Community Medicine Residency Program, McGill University, Montréal, QC.
Can J Public Health. 2011 Mar-Apr;102(2):108-11. doi: 10.1007/BF03404157.
To study the trend of hospital stays for patients diagnosed with pulmonary TB in Montreal from 1993 to 2007.
From the registry of hospital discharge summary information, we selected first hospitalizations for patients with a diagnosis of TB, and from the reportable diseases registry, patients with culture positive pulmonary TB. We linked the selected cases, using the first 3 characters of postal code of residence, sex and age. From the linked cases, we included those for whom date of patient's admission to hospital (from the former registry) was similar to the date of notification to the public health department (from the latter registry), while allowing for an appropriate variation.
Among the 563 linked cases, the median duration of hospitalization was 17.0 days. Duration of hospitalization did not significantly decrease during the study period. Cases with positive sputum smear were more likely to stay in hospital > or = 14 days compared to those without one (OR = 1.90, 95% CI: 1.34-2.70). TB cases > or = 50 years of age remained in hospital longer than those between 18-49 years of age (OR = 1.66, 95% CI: 1.15-2.40).
For 63.9% (360) of the cases studied, the duration of hospitalization was > or = 14 days, which is consistent with the minimum recommended hospital stay for patients with pulmonary TB in Canada. Further studies are necessary to examine the impact of discharging hospitalized TB patients before 14 days of hospital stay on the risk of TB transmission in the community.
研究 1993 年至 2007 年期间蒙特利尔因肺结核住院患者的住院趋势。
我们从住院记录摘要信息登记处中选择初次确诊为肺结核的患者住院记录,从法定传染病报告登记处中选择培养阳性肺结核患者。使用居住地邮政编码的前 3 位字符、性别和年龄,对选定病例进行了链接。在链接病例中,我们纳入了患者入院日期(来自前一个登记处)与向公共卫生部门报告的日期(来自后一个登记处)相似的病例,同时允许存在适当的差异。
在 563 例链接病例中,中位住院时间为 17.0 天。在研究期间,住院时间没有明显减少。痰涂片阳性的病例比痰涂片阴性的病例更有可能住院时间 >或= 14 天(比值比=1.90,95%置信区间:1.34-2.70)。 >或= 50 岁的肺结核病例比 18-49 岁的病例住院时间更长(比值比=1.66,95%置信区间:1.15-2.40)。
在所研究的 360 例病例中,有 63.9%(360)的病例住院时间 >或= 14 天,这与加拿大肺结核患者的最短推荐住院时间一致。需要进一步研究,以检验在住院 14 天之前提前出院对社区中肺结核传播风险的影响。