韩国一家三级医院的老年结核病患者的临床特征。

Clinical features of octogenarian patients with tuberculosis at a tertiary hospital in South Korea.

作者信息

Min Jinsoo, Mi Shin Yoon, Lee Won Jae, Truong Tung Thanh, Kang Eun Seok, An Jin Young, Choe Kang Hyeon, Man Lee Ki

机构信息

1 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea.

2 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.

出版信息

J Int Med Res. 2019 Jan;47(1):271-280. doi: 10.1177/0300060518800597. Epub 2018 Oct 21.

DOI:10.1177/0300060518800597

PMID:30343587

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6384473/

Abstract

OBJECTIVE

The growth of the older population is a great challenge for tuberculosis (TB) control in South Korea. This study was performed to investigate the clinical characteristics of and treatment outcomes among octogenarian patients with TB.

METHODS

We retrospectively analyzed the medical records of 109 patients with TB (age of ≥80 years) from January 2014 to March 2017. Clinical, microbiologic, and radiologic findings were obtained.

RESULTS

Fifty-five patients (50.5%) were male, the mean age of the patients was 83.8 years, and 75 patients (68.8%) had pulmonary TB. All patients with pulmonary TB underwent either chest X-ray or chest computed tomography examination, and the results showed that only one-third (n = 33, 39.3%) had active lesions suggestive of TB. Twenty-nine patients (26.4%) had an unfavorable outcome (21 died and 8 were lost to follow-up). Only two TB-related deaths occurred, and both were caused by respiratory failure. Among the 15 non-TB-related deaths, the progression of malignancy and sepsis were the most frequent causes of death.

CONCLUSIONS

A high mortality rate was observed in octogenarian patients with TB, and most of these deaths were non-TB-related. Among all causes of mortality, solid malignancy was a significant risk factor for death.

摘要

目的

老年人口的增长对韩国的结核病控制构成了巨大挑战。本研究旨在调查80岁及以上结核病患者的临床特征和治疗结果。

方法

我们回顾性分析了2014年1月至2017年3月期间109例结核病患者（年龄≥80岁）的病历。获取了临床、微生物学和放射学检查结果。

结果

55例（50.5%）为男性，患者的平均年龄为83.8岁，75例（68.8%）患有肺结核。所有肺结核患者均接受了胸部X线或胸部计算机断层扫描检查，结果显示只有三分之一（n = 33，39.3%）有提示结核病的活动性病变。29例（26.4%）患者预后不良（21例死亡，8例失访）。仅发生了2例与结核病相关的死亡，均由呼吸衰竭引起。在15例与结核病无关的死亡中，恶性肿瘤进展和败血症是最常见的死亡原因。