Decreased activities of daily living is a strong risk factor for liver injury by anti-tuberculosis drugs

Authors


  • Associate Editor: Chi Chui Leung

Correspondence: Nobuyuki Horita, Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. Email: nobuyuki_horita@yahoo.co.jp

Abstract

Background and objective

We evaluated the association between activities of daily living and drug-induced liver injury by anti-tuberculosis drugs.

Methods

This retrospective cohort study included adult inpatients with newly diagnosed smear-positive lung tuberculosis treated with standard regimen in two hospitals. (n = 346; 63.6 ± 20.3 years old; 106 (30.6%) females). Activities of daily living was divided into ‘independent’ (Barthel Index (BI) 80–100, 60.4%) and ‘decreased’ (BI 0–75, 39.6%) categories. Liver injury was defined as the withdrawal or change of treatment regimen on the basis of the following criteria: serum transaminase concentrations were more than three times the upper limit of normal range with jaundice and/or hepatitis symptoms, or more than five times the upper limit of the normal range.

Results

Compared with ‘independent’ patients, patients with ‘decreased’ activities of daily living had odds ratios for liver injury of 4.2 (P < 0.001) in univariate analysis and 5.7 (P = 0.002) in logistic regression analysis after adjusting for other risk factors.

Conclusions

Decreased activity of daily living is a strong risk factor for liver injury among adult inpatients with newly diagnosed smear-positive lung tuberculosis treated using a standard regimen.

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