Clinical, Radiological Features and Treatment Outcomes of Tuberculosis in Patients Aged 75 Years and Older.

IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Epidemiology and Global Health Pub Date : 2024-10-29 DOI:10.1007/s44197-024-00311-8
Afrah Alsehali, Haneen Alrajih, Hamdan Al-Jahdali, Eiman Al-Safi, Laila Layqah, Salim Baharoon
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Abstract

Introduction: Tuberculosis (TB) is a significant contributor to morbidity and mortality. With a progressively aging population, TB is increasingly encountered in older adults. Understanding the clinical presentation and optimal treatment strategies for TB in this population is essential.

Method: Clinical, radiological features, treatment, and outcome of patients aged 75 and above who were diagnosed with tuberculosis at King Abdulaziz Medical City in Riyadh in the period between January 2015 to December 2021wereevaluated retrospectively.

Results: Among 92 elderly tuberculosis patients, most were male (76.1%) with a mean age of 82.5 years. Pulmonary TB was diagnosed in 52.2% of patients, Extra Pulmonary TB in 32.6%, and Disseminated TB in 15.2%. Comorbidities included Diabetes Mellitus (59.8%) and Congestive Heart Failure (41.3%). The most common presentation symptoms included cough (51.1%), fever (43.5%), dyspnea (39.1%), and weight loss (31.5%). Delay of TB diagnosis for up to 3 months was observed in 31.5% of patients. Weight loss and male gender were significant predictors of delayed diagnosis. Laboratory findings varied among TB types, with disseminated TB showing higher eosinophilia and thrombocytopenia. Completion of an initial RIPE treatment protocol was achieved in 67.6% of patients. Mortality during treatment occurred in 23.9% of patients. Pulmonary TB was associated with higher mortality compared to extrapulmonary TB (p = 0.007).

Conclusion: Tuberculosis is associated with high mortality in patients above the age of 75. There is still a substantial delay in TB diagnosis in the elderly. RIPE regimen is frequently changed due to side effects. Alternative regimen choices were quite variable. More studies on tuberculosis in this patient's population are needed to define the most effective therapeutic approach.

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75 岁及以上肺结核患者的临床、放射学特征和治疗效果。
导言:结核病(TB)是导致发病和死亡的一个重要因素。随着人口老龄化的加剧,结核病越来越多地发生在老年人身上。了解老年人结核病的临床表现和最佳治疗策略至关重要:方法:对 2015 年 1 月至 2021 年 12 月期间在利雅得阿卜杜勒阿齐兹国王医疗城确诊为肺结核的 75 岁及以上患者的临床、放射学特征、治疗和结果进行回顾性评估:在92名老年肺结核患者中,大多数为男性(76.1%),平均年龄为82.5岁。52.2%的患者确诊为肺结核,32.6%确诊为肺外结核,15.2%确诊为播散性结核。合并症包括糖尿病(59.8%)和充血性心力衰竭(41.3%)。最常见的症状包括咳嗽(51.1%)、发热(43.5%)、呼吸困难(39.1%)和体重减轻(31.5%)。31.5%的患者结核病诊断延迟长达3个月。体重减轻和男性是延迟诊断的重要预测因素。不同类型肺结核的实验室检查结果各不相同,播散性肺结核的嗜酸性粒细胞和血小板减少率较高。67.6%的患者完成了最初的RIPE治疗方案。23.9%的患者在治疗期间死亡。肺结核的死亡率高于肺外结核(P = 0.007):结论:肺结核与 75 岁以上患者的高死亡率有关。结论:肺结核与 75 岁以上患者的高死亡率有关。RIPE 方案经常因副作用而改变。替代疗法的选择相当多变。需要对这类患者的结核病进行更多研究,以确定最有效的治疗方法。
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来源期刊
CiteScore
10.70
自引率
1.40%
发文量
57
审稿时长
19 weeks
期刊介绍: The Journal of Epidemiology and Global Health is an esteemed international publication, offering a platform for peer-reviewed articles that drive advancements in global epidemiology and international health. Our mission is to shape global health policy by showcasing cutting-edge scholarship and innovative strategies.
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