Long-Term Mortality After Tuberculosis Among People With Disabilities in Korea

Background: Given the increased vulnerability of people with disabilities to poor health outcomes, we evaluated the impact of disability on long-term mortality among tuberculosis (TB) survivors. Methods: We conducted a nationwide population-based cohort study using the linked national registry databases in the Republic of Korea. The study included 305,055 TB patients diagnosed between 2008 and 2016 who survived at least 1 year. The primary outcome was to compare long-term mortality after TB diagnosis between people with and without disabilities. Long-term mortality was defined as all-cause mortality at least 1 year after TB diagnosis. Cox proportional hazard models were used to evaluate the risk of long-term mortality. Subgroup and sensitivity analyses were performed based on disability type, severity, and cause of death. Results: Disabilities were present in 10.1% of survivors and were associated with higher mortality rates (46.3 vs. 16.3 per 1,000 person-years, P < 0.001). Cox analysis revealed that disabilities increased long-term mortality risk, with severe disabilities posing the highest risk. Respiratory disabilities were strongly linked to deaths both related and unrelated to TB. Conclusion: Long-term mortality risk is significantly higher in TB survivors with disabilities.