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HbA1c level cannot predict the treatment outcome of smear-positive non-multi-drug-resistant HIV-negative pulmonary tuberculosis inpatients.

HbA1c level cannot predict the treatment outcome of smear-positive non-multi-drug-resistant HIV-negative pulmonary tuberculosis inpatients.
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Tashiro K, Horita N, Nagai K, Ikeda M, Shinkai M, Yamamoto M, Sato T, Hara Y, Nagakura H, Shibata Y, Watanabe H, Nakashima K, Ushio R, Nagashima A, Narita A, Kobayashi N, Kudo M, Kaneko T,


Tashiro K, Horita N, Nagai K, Ikeda M, Shinkai M, Yamamoto M, Sato T, Hara Y, Nagakura H, Shibata Y, Watanabe H, Nakashima K, Ushio R, Nagashima A, Narita A, Kobayashi N, Kudo M, Kaneko T, (click to view)

Tashiro K, Horita N, Nagai K, Ikeda M, Shinkai M, Yamamoto M, Sato T, Hara Y, Nagakura H, Shibata Y, Watanabe H, Nakashima K, Ushio R, Nagashima A, Narita A, Kobayashi N, Kudo M, Kaneko T,

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Scientific reports 2017 04 137() 46488 doi 10.1038/srep46488
Abstract

We conducted a single-center retrospective cohort study to evaluate whether the HbA1c level on admission could predict the in-hospital treatment outcome of smear-positive non-multi-drug-resistant HIV-negative culture-proven pulmonary tuberculosis inpatients. Our standard regimens under the direct observation were HRZE or HRE for the first two months followed by combination therapy with isoniazid and rifampicin. Our cohort consisted of consecutive 239 patients consisted of 147 men and 92 women with a median age of 73 years. The HbA1c level of patients whose HbA1c was above 7.0% on admission showed clear declining trends after admission. HbA1c on admission had no Spearman’s rank correlation with time to discharge alive (r = 0.17) and time to becoming non-infective (r = 0.17). By Kaplan-Meier curves and a log-rank trend test, HbA1c quartile subgroups showed no association with times to discharge alive (p = 0.431), becoming non-infective (p = 0.113), and in-hospital death (p = 0.427). Based on multi-variate Cox analysis, HbA1c on admission had no significant impact on time to discharge alive (hazard ratio = 1.03, 95% CI 0.89-1.20, p = 0.659), becoming non-infective (hazard ratio = 0.93, 95% CI 0.80-1.06, p = 0.277), and in-hospital death (hazard ratio = 0.68, 0.43-1.07, p = 0.097). In conclusion, the HbA1c level on admission did not seem to affect in-hospital tuberculosis treatment outcomes in Japanese cohort.

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