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Main arrow Archive of previous Issues arrow ╣3 2011 (19) arrow The results of the cohort trial of management of primary patients with destructive lung tb in the rf: prospective analysis
The results of the cohort trial of management of primary patients with destructive lung tb in the rf: prospective analysis Print
Saturday, 01 October 2011

Summary. Background: It is generally considered that in the RF just a little than half (=53.6%) of primary patients with destructive lung TB with initiated therapy course really had completed it in full scale. Most common cause of inefficiency of chemotherapy course is lack of its completion or refusal of a patient to continue treatment.

Methods: Retrospective data from the RF cohort trial for 2008 in 76 RF local districts on the outcomes of treatment of primary patients with destructive lung TB in the RF were used for correlation and regression analysis in this statistical survey. A program STATISTICA 6.1 StatSoft, Inc.(2003) was used for calculation.

Results: Statistical analysis of retrospective data from the RF cohort trial for 2008 on the results of treatment of primary patients with destructive lung TB in the RF demonstrated that in those RF districts where discontinuation/intermittence in treatment were registered more often, the patients also died reliably more often, while in those RF districts where discontinuation/intermittence in treatment were registered less often, the patients also died reliably less often.

In 2008, 25.2% of total TB mortality in the RF in insufficiently treated/treatment discontinued TB patients had fallen into the group of primary patients with destructive lung TB (died from this destructive TB).

In those RF districts where surgical treatment in comprehensive treatment of primary patients with destructive lung TB was registered more often, the efficient cure occurred reliably also more often, while in those RF districts where surgical treatment in comprehensive treatment of primary patients with destructive lung TB was registered less often, i.e. was rarely/occasionally implemented, the efficient cure occurred reliably more rarely.

Discussion: Interestingly, the utilized here cohort trial pointed no verifiable correlations between intermittence in comprehensive chemotherapy and multidrug resistance Mycobacterium tuberculosis. This lacuna could readily be pre-determined by widespread variability of data concerning multidrug resistance Mycobacterium tuberculosis. This drawback of the trial necessitates further prospective studies.

Conclusions: Analysis of the data from the cohort trial demonstrated that efficiency of treatment of primary patients with destructive lung TB is still of low grade: only 53.6% of them did complete it in full scale. Every interruption due to discontinuation/intermittence of the treatment course for the primary patients with destructive lung TB constitutively elevated the risk of mortal outcome. The more often the surgical treatment is implemented in comprehensive treatment of primary patients with destructive lung TB, the more efficient the management was.

Key words. cohort analysis, treatment outcomes, destructive lung TB, primary patients, surgical treatment.

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