Hospital Estadual Santa Maria, Secretaria de Estado de Saúde e Defesa Civil do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
J Bras Pneumol. 2009 Aug;35(8):780-7. doi: 10.1590/s1806-37132009000800010.
To determine the epidemiological profile of inpatients at a TB referral hospital.
This was a descriptive, retrospective study of the medical charts of patients with TB hospitalized at the Hospital Estadual Santa Maria (HESM), in the city of Rio de Janeiro, Brazil, between January of 2002 and December of 2003. Data were collected using a standardized form.
Of the 451 patients included in the study, 313 (69.4%) had been referred to the HESM from health care clinics, and 302 (67.0%) were male. Most of the patients were in the 30-59 year age bracket, 443 (98.2%) lived in the greater metropolitan region of Rio de Janeiro, and 298 (66.1%) lived in the city of Rio de Janeiro itself. The most common reason for hospitalization was poor health status (in 237, 52.5%). The most common comorbidity was AIDS (in 137, 30.4%). The most common signs and symptoms at admission were weight loss, fever and productive cough. Sputum smear microscopy was positive in 122 (71.0%) of the patients presenting with productive cough at admission. Of the 212 patients being retreated, 156 (73.6%) reported noncompliance with previous treatment. Regarding the outcome, 273 (65.8%) of the patients were referred to municipal health care centers, 83 (18.4%) died, 44 (9.8%) were cured, and 27 (6%) were discharged against medical advice.
Providing hospitals specializing in TB is relevant for TB control, especially in metropolitan regions. In addition to taking biosafety measures, these hospitals must be prepared to treat patients with TB-related comorbidities and social problems. This study has resulted in improvements at the HESM.
确定结核病转诊医院住院患者的流行病学特征。
这是一项对巴西里约热内卢市圣玛丽亚州立医院（HESM）住院结核病患者病历的描述性、回顾性研究。数据通过标准化表格收集。
在纳入研究的 451 名患者中，313 名（69.4%）是从卫生保健诊所转诊到 HESM 的，302 名（67.0%）为男性。大多数患者年龄在 30-59 岁之间，443 名（98.2%）居住在里约热内卢大都市区，298 名（66.1%）居住在里约热内卢市。住院的最常见原因是健康状况不佳（237 例，52.5%）。最常见的合并症是艾滋病（137 例，30.4%）。入院时最常见的体征和症状是体重减轻、发热和咳痰。入院时有咳痰症状的 122 名患者（71.0%）痰涂片镜检阳性。在 212 名复治患者中，156 名（73.6%）报告以前的治疗不依从。关于结局，273 名（65.8%）患者被转介到市立卫生保健中心，83 名（18.4%）死亡，44 名（9.8%）治愈，27 名（6%）因拒绝医疗建议而出院。
为结核病专科医院提供服务对结核病控制至关重要，特别是在大都市地区。除了采取生物安全措施外，这些医院还必须准备好治疗结核病相关合并症和社会问题的患者。这项研究已经在 HESM 取得了改进。
