Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy.
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy; Pediatric Infectious Diseases Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, 90127 Palermo, Italy.
J Infect Public Health. 2023 Sep;16(9):1518-1524. doi: 10.1016/j.jiph.2023.06.015. Epub 2023 Jun 24.
Very few data are available in the literature regarding tuberculosis (TB) hospitalization, and few studies have reported the clinical characteristics and comorbidities of admitted patients and burden and cost of hospitalization. In our study, we described the occurrence of TB hospital admissions in the southern Italian region of Sicily over 13 years (2009-2021), explored the characteristics of patients with TB, and determined the comorbidities associated with mortality.
Data on the hospital discharge of all patients with TB hospitalized in all Sicilian hospitals were retrospectively collected from hospital standard discharge forms. Age, sex, nationality, length of hospital stay, comorbidities, and TB localization were evaluated using univariate analysis according to in-hospital mortality. The factors associated with mortality were included in the logistic regression model.
In Sicily, 3745 people were hospitalized for TB, with 5239 admissions and 166 deaths from 2009 to 2021. Most hospitalizations involved Italian-born people (46.3%), followed by African-born people (32.8%) and Eastern European-born people (14.1%). The average hospitalization cost was EUR 5259 ± 2592, with a median length of stay of 16 days (interquartile range, 8-30) days. Multivariate analysis showed that the development of acute kidney failure (adjusted odds ratio [aOR]=7.2, p < 0.001), alcohol consumption (aOR=8.9, p = 0.001), malignant tumors (aOR=2.1, p = 0.022), human immunodeficiency virus infection (aOR=3.4, p < 0.001), sepsis (aOR=15.2, p < 0.001), central nervous system involvement (aOR=9.9, p < 0.001), and miliary TB (aOR=2.5, p = 0.004) were independent predictors of mortality.
TB in Sicily remains an important cause of hospitalization. HIV infection and comorbidities may complicate patient management and worsen patient outcomes.
关于结核病（TB）住院治疗，文献中仅有很少的数据，且很少有研究报告住院患者的临床特征和合并症以及住院的负担和费用。在我们的研究中，我们描述了 13 年来（2009-2021 年）西西里岛南部意大利地区结核病住院的发生情况，探讨了结核病患者的特征，并确定了与死亡率相关的合并症。
从医院标准出院表中回顾性收集了所有在西西里岛所有医院住院的结核病患者的住院数据。根据院内死亡率，使用单变量分析评估年龄、性别、国籍、住院时间、合并症和结核病定位。将与死亡率相关的因素纳入逻辑回归模型。
2009 年至 2021 年，西西里岛共有 3745 人因结核病住院治疗，5239 人入院，166 人死亡。大多数住院患者为意大利出生（46.3%），其次是非洲出生（32.8%）和东欧出生（14.1%）。平均住院费用为 5259 欧元±2592 欧元，中位住院时间为 16 天（四分位间距 8-30 天）。多变量分析显示，急性肾衰竭（调整优势比[aOR]=7.2，p<0.001）、饮酒（aOR=8.9，p=0.001）、恶性肿瘤（aOR=2.1，p=0.022）、人类免疫缺陷病毒感染（aOR=3.4，p<0.001）、脓毒症（aOR=15.2，p<0.001）、中枢神经系统受累（aOR=9.9，p<0.001）和粟粒性结核病（aOR=2.5，p=0.004）是死亡的独立预测因素。
西西里岛的结核病仍然是住院的重要原因。HIV 感染和合并症可能会使患者的治疗复杂化，并导致患者的预后恶化。
