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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
Risk factors for tuberculosis after gastrectomy in gastric cancer
Won Jai Jung, Young Mok Park, Joo Han Song, Kyung Soo Chung, Song Yee Kim, Eun Young Kim, Ji Ye Jung, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Sung Hoon Noh, Ji Yeong An, Young Ae Kang
Won Jai Jung, Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Seoul 120-752, South Korea
Young Mok Park, Joo Han Song, Kyung Soo Chung, Song Yee Kim, Eun Young Kim, Ji Ye Jung, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Young Ae Kang, Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul 120-752, South Korea
Sung Hoon Noh, Ji Yeong An, Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, South Korea
Author contributions: Jung WJ, An JY and Kang YA designed the research; Jung WJ and Park YM wrote the paper; Song JH, Kim SY, Kim EY and Noh SH acquired the data; Jung WJ, Chung KS, Jung JY and Park MS analyzed the data; Kim YS, Kim SK, Chang J, An JY and Kang YA reviewed and edited the paper; An JY and Kang YA contributed equally to this article; All authors read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Severance Hospital (IRB No. 4-2014-0506).
Conflict-of-interest statement: None of the authors has a conflict of interest.
Data sharing statement: The technical appendix, statistical codes, and dataset are available from the corresponding author at mdkang@yuhs.ac. Consent was not obtained but the data presented were anonymized; thus, the risk of identification is low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Young Ae Kang, MD, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea. mdkang@yuhs.ac
Telephone: +82-2-22281986 Fax: +82-2-3936884
Received: July 2, 2015
Peer-review started: July 6, 2015
First decision: July 19, 2015
Revised: September 18, 2015
Accepted: November 30, 2015
Article in press: December 1, 2015
Published online: February 28, 2016
AIM: To examine incidence of tuberculosis (TB) in gastrectomy patients and investigate the risk factors for developing TB after gastrectomy in patients with gastric cancer.
METHODS: A retrospective cohort study of gastrectomy patients with gastric cancer was performed at a university-affiliated hospital in Seoul, South Korea between January 2007 and December 2009. We reviewed patient medical records and collected data associated with the risk of TB, surgery, and gastric cancer. Standardized incidence ratios (SIRs) of TB were calculated to compare the incidence of TB in gastrectomy patients with that in the general Korean population, and risk factors for TB after gastrectomies were analyzed.
RESULTS: Among the 1776 gastrectomy patients, 0.9% (16/1776) developed post-gastrectomy TB, with an incidence of 223.7 cases per 100000 patients per year. The overall incidence of TB in gastrectomy patients, adjusted by sex and age, was significantly higher than that in the general population (SIR = 2.22, 95%CI: 1.27-3.60). Previous TB infection [odds ratio (OR) = 7.1, P < 0.001], lower body mass index (BMI) (kg/m2; OR = 1.21, P = 0.043) and gastrectomy extent (total gastrectomy vs subtotal gastrectomy) (OR = 3.48, P = 0.017) were significant risk factors for TB after gastrectomy in a multivariate analysis.
CONCLUSION: TB incidence after gastrectomy is higher than that in the general population. Previous TB infection, lower BMI, and total gastrectomy are risk factors for TB after gastrectomy in patients with gastric cancer.
Core tip: The incidence of tuberculosis (TB) in patients who underwent gastrectomy was found to be more than two-times higher than that in the general population. Also, we found that a previous TB infection [odds ratio (OR) = 7.1, P < 0.001], gastrectomy extent (total gastrectomy vs subtotal gastrectomy) (OR = 3.48, P = 0.017) and lower body mass index (kg/m2; OR = 1.21, P = 0.043) were significant risk factors for TB after gastrectomy in gastric cancer.
