Chronic lung disease and a history of tuberculosis (post-tuberculosis lung disease): Clinical features and in-hospital outcomes in a resource-limited setting with a high HIV burden
| Autor: | F Nomvete, Rudzani Muloiwa, Senlika Naidoo, L C Mbanga, Sipho Dlamini, P Mkoko |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty congenital hereditary and neonatal diseases and abnormalities Tuberculosis 030106 microbiology lcsh:Medicine HIV Infections Comorbidity South Africa 03 medical and health sciences 0302 clinical medicine Cost of Illness Risk Factors Interquartile range Internal medicine medicine Humans Hospital Mortality 030212 general & internal medicine Tuberculosis Pulmonary Aged Retrospective Studies History of tuberculosis lcsh:R5-920 Coinfection business.industry Public health lcsh:R Retrospective cohort study General Medicine Middle Aged Prognosis medicine.disease respiratory tract diseases Hospitalization Hospital outcomes Lung disease Chronic Disease Disease Progression Health Resources Female lcsh:Medicine (General) business Follow-Up Studies |
| Zdroj: | SAMJ: South African Medical Journal, Volume: 109, Issue: 3, Pages: 169-173, Published: MAR 2019 South African Medical Journal; Vol 109, No 3 (2019); 169-173 South African Medical Journal, Vol 109, Iss 3, Pp 169-173 (2019) |
| ISSN: | 2078-5135 |
| Popis: | Background. Many patients with previous pulmonary tuberculosis (PTB) continue to experience respiratory symptoms long after completion of tuberculosis (TB) therapy, often resulting in numerous hospital visits and admissions.Objectives. To describe the profile of patients with chronic lung disease (CLD) with or without a history of PTB, and their in-hospital outcomes.Methods. We conducted a retrospective review of patients with CLD admitted with respiratory symptoms to Dora Nginza Hospital, Port Elizabeth, South Africa, from 1 April 2016 to 31 October 2016. These patients were divided into two groups: CLD with a history of PTB (CLD-TB) and CLD without a history of PTB. Patients with current culture-positive TB were excluded. Baseline characteristics and clinical outcomes (duration of hospitalisation and in-hospital mortality) were compared between the two groups.Results. During the study period, a total of 4 884 patients were admitted and 242 patients received a diagnosis of CLD. In the CLD patient group, 173 had CLD-TB and 69 had no history of PTB. Patients with CLD-TB presented with respiratory symptoms a median of 41 months (interquartile range (IQR) 101) after completion of TB therapy. CLD-TB patients were predominantly male (59.5%), and compared with patients with no history of PTB were more likely to be HIV-positive (49.7% v. 8.7%; p=0.001) and had had more frequent hospital admissions before the current admission (median 2.0 (IQR 2.0) v. 0; p=0.001) and longer hospital stays (median 5 days (IQR 7) v. 2 (4); p=0.002). However, there was no statistically significant difference in in-hospital mortality between the two groups (17.3% v. 10.1%; p=0.165).Conclusions. In patients with CLD, a history of PTB is associated with numerous hospital admissions and longer hospital stays but not with increased in-hospital mortality. TB therefore continues to be a public health burden long after cure of active disease. |
| Databáze: | OpenAIRE |
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