Culqui Dante R, Rodríguez-Valín Elena, Martínez de Aragón M Victoria
Programa de Epidemiología de Campo PEAC, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; Programa de Doctorado en Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid, Madrid, España.
Área de Análisis en Vigilancia Epidemiológica, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
Enferm Infecc Microbiol Clin. 2015 Jan;33(1):9-15. doi: 10.1016/j.eimc.2013.12.015. Epub 2014 Mar 27.
The National Hospital Discharge Registry is a clinical-administrative database on hospital discharges, which is very useful at a regional level as a complementary source for surveillance. There are few national studies on tuberculosis (TB) using the National Hospital Discharge Registry, thus it was considered of interest to study the characteristics and trends of hospital discharges for TB in Spain.
A descriptive study was performed using the main variables in the National Hospital Discharge Registry (sex, age, main diagnosis, type of discharge, length of stay), and trend analysis of hospitalization rates per 100,000 population, as well as primary diagnosis, by sex, age group, and type of TB (pulmonary [TBP]/extrapulmonary [TBEP]), for the period 1999-2009 in Spain.
A total of 65,609 hospital discharges were included in the study (66% male, 66% TBP, and 52% between 15-44 years). The overall rate of TB for the entire hospitalization period was 13.93 per 100,000 inhabitants, being 18.83 in males and 9.18 in females. The hospitalization rates for TBP and TBEP decreased in the period 1999-2009 in both sexes (TBP in males, from 18 to 13, and in females, from 8 to 6; TBEP in males from 4 to 3, and from 3 to 2 in female hospitalizations/100,000 habitants). In TBP, children are those with a smallest decline, and in TBEP there is an increase in males in all age groups from 2005.
The results are consistent with those from surveillance. The slow decline in rates in children and the increase in extrapulmonary forms in males may be related to immigration, so it is necessary to improve TB monitoring in these groups.
国家医院出院登记处是一个关于医院出院情况的临床管理数据库，在区域层面作为监测的补充来源非常有用。利用国家医院出院登记处进行的关于结核病（TB）的全国性研究很少，因此研究西班牙结核病医院出院情况的特征和趋势被认为是有意义的。
使用国家医院出院登记处的主要变量（性别、年龄、主要诊断、出院类型、住院时间）进行描述性研究，并对1999 - 2009年西班牙每10万人口的住院率以及按性别、年龄组和结核病类型（肺结核[TBP]/肺外结核[TBEP]）划分的主要诊断进行趋势分析。
该研究共纳入65609例医院出院病例（男性占66%，肺结核占66%，15 - 44岁年龄段占52%）。整个住院期间结核病的总体发病率为每10万居民13.93例，男性为18.83例，女性为9.18例。1999 - 2009年期间，男女的肺结核和肺外结核住院率均有所下降（男性肺结核从18降至13，女性从8降至6；男性肺外结核从4降至3，女性住院率从3降至2/10万居民）。在肺结核方面，儿童的下降幅度最小，而在肺外结核方面，从2005年起所有年龄组的男性发病率均有所上升。
结果与监测结果一致。儿童发病率下降缓慢以及男性肺外结核形式增加可能与移民有关，因此有必要加强对这些群体的结核病监测。
