台湾急诊科肺结核延迟诊断的相关因素。
Factors associated with delayed recognition of pulmonary tuberculosis in emergency departments in Taiwan.
作者信息
Yen Yung-Lin, Chen I-Chuan, Wu Chien-Hung, Li Wen-Cheng, Wang Cheng-Hsien, Tsai Tsung-Cheng
机构信息
Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung County, Taiwan.
Department of Emergency Medicine, Chang Gung Memorial Hospital, No.6, W. Sec., Jiapu Rd., Puzih City, Chiayi County 613, Taiwan; Chang Gung University College of Medicine, No.5, Fusing St., Gueishan Township, Taoyuan County 333, Taiwan.
出版信息
Heart Lung. 2015 Jul-Aug;44(4):353-9. doi: 10.1016/j.hrtlng.2015.03.004. Epub 2015 Apr 27.
OBJECTIVE
To identify and evaluate factors associated with delayed recognition of pulmonary tuberculosis (TB) in the emergency department (ED).
BACKGROUND
Delayed recognition of pulmonary TB in ED may precipitate mortality and morbidity.
METHODS
Medical records of newly diagnosed TB patients admitted to four hospitals in Taiwan were retrospectively reviewed. Patients were divided into two groups based on ED physicians' recognition or not of TB and statistically compared to identify differences in their characteristics.
RESULTS
310 newly diagnosed TB patients were identified; 150 were unrecognized in the ED. Cough, chest tightness, general malaise, and body weight loss were more common for those with recognized TB. Older age (≥65 yrs, P = 0.035) and chronic renal insufficiency (P = 0.005) were associated with delayed TB recognition.
CONCLUSION
Older age and chronic renal insufficiency are risk factors for delayed TB while in the ED. Typical symptoms should heighten alertness for recognizing TB.
目的
识别并评估与急诊科（ED）肺结核（TB）诊断延迟相关的因素。
背景
急诊科对肺结核的诊断延迟可能会增加死亡率和发病率。
方法
回顾性分析台湾四家医院新确诊结核病患者的病历。根据急诊科医生是否诊断出结核病，将患者分为两组，并进行统计学比较，以确定其特征差异。
结果
共识别出310例新确诊的结核病患者；其中150例在急诊科未被诊断出。咳嗽、胸闷、全身乏力和体重减轻在已诊断出结核病的患者中更为常见。年龄较大（≥65岁，P = 0.035）和慢性肾功能不全（P = 0.005）与结核病诊断延迟有关。
结论
年龄较大和慢性肾功能不全是急诊科结核病诊断延迟的危险因素。典型症状应提高对结核病诊断的警惕性。
Zotero 插件