Factors Associated with the Survival of Patients with Melioidosis at Buriram Hospital, Buriram Province

Abstract

This retrospective cohort study aimed to investigate factors associated with the survival of melioidosis patients after diagnosis and treatment at Buriram Hospital, Buriram Province, from 2019-2023. A total of 631 patients diagnosed with melioidosis confirmed by culture between January 1, 2019, and December 31, 2023, were included. Patients were followed up until their final status was ascertained on December 31, 2024. Survival rates were analyzed using the Kaplan-Meier method with 95% confidence intervals (CI). Group comparisons were performed using the Log-rank test with reported p-values. Cox proportional hazards regression was conducted to identify factors associated with survival, presenting adjusted HR with 95% CI and p-values from the partial likelihood ratio test. The research finding 1, 3, and 5-year survival rates were 91.32% (95% CI: 88.67 - 93.38), 90.81% (95% CI: 88.06 - 92.96), and 90.38% (95% CI: 87.47 - 92.64), respectively. Acute respiratory failure was found to be significantly associated with survival (p < 0.05). After adjusting for age, diabetes, type of infection, and creatinine levels, patients with acute respiratory failure had a 4.68-fold higher risk of death compared to those without this complication (adjusted HR = 4.68, 95% CI: 2.49 - 8.78).

These findings indicate that acute respiratory failure is a critical factor affecting the survival of melioidosis patients treated at Buriram Hospital. This complication often occurs after the onset of symptoms. Close monitoring and assessment of complications can reduce disease severity, prevent critical conditions, and effectively improve patient survival.