Clinical, Radiological Features and Treatment Outcomes of Tuberculosis in Patients Aged 75 Years and Older.

Autor: Alsehali A; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.; Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia., Alrajih H; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.; Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia., Al-Jahdali H; Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.; King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia.; Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia., Al-Safi E; Ministry of Health, Al-Yamama Hospital Riyadh Second Health Cluster, Riyadh, Saudi Arabia., Layqah L; Research Offices, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.; King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia.; Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia., Baharoon S; Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Baharoon@hotmail.com.; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. Baharoon@hotmail.com.; King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia. Baharoon@hotmail.com.; Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia. Baharoon@hotmail.com.; Department of Critical Care, Division of Infectious diseases, Department of Medicine, King Abdulaziz Medical City, MNGHA, Riyadh, 11426, Saudi Arabia. Baharoon@hotmail.com.
Jazyk: angličtina
Zdroj: Journal of epidemiology and global health [J Epidemiol Glob Health] 2024 Oct 29. Date of Electronic Publication: 2024 Oct 29.
DOI: 10.1007/s44197-024-00311-8
Abstrakt: Introduction: Tuberculosis (TB) is a significant contributor to morbidity and mortality. With a progressively aging population, TB is increasingly encountered in older adults. Understanding the clinical presentation and optimal treatment strategies for TB in this population is essential.
Method: Clinical, radiological features, treatment, and outcome of patients aged 75 and above who were diagnosed with tuberculosis at King Abdulaziz Medical City in Riyadh in the period between January 2015 to December 2021wereevaluated retrospectively.
Results: Among 92 elderly tuberculosis patients, most were male (76.1%) with a mean age of 82.5 years. Pulmonary TB was diagnosed in 52.2% of patients, Extra Pulmonary TB in 32.6%, and Disseminated TB in 15.2%. Comorbidities included Diabetes Mellitus (59.8%) and Congestive Heart Failure (41.3%). The most common presentation symptoms included cough (51.1%), fever (43.5%), dyspnea (39.1%), and weight loss (31.5%). Delay of TB diagnosis for up to 3 months was observed in 31.5% of patients. Weight loss and male gender were significant predictors of delayed diagnosis. Laboratory findings varied among TB types, with disseminated TB showing higher eosinophilia and thrombocytopenia. Completion of an initial RIPE treatment protocol was achieved in 67.6% of patients. Mortality during treatment occurred in 23.9% of patients. Pulmonary TB was associated with higher mortality compared to extrapulmonary TB (p = 0.007).
Conclusion: Tuberculosis is associated with high mortality in patients above the age of 75. There is still a substantial delay in TB diagnosis in the elderly. RIPE regimen is frequently changed due to side effects. Alternative regimen choices were quite variable. More studies on tuberculosis in this patient's population are needed to define the most effective therapeutic approach.
(© 2024. The Author(s).)
Databáze: MEDLINE
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