Tuberculosis en pacientes mayores de 80 años atendidos en una institución de alta complejidad

José Fernando García-Goez; Hernán Esteban Munévar; Robinson Pacheco

doi:10.30789/rcneumologia.v29.n1.2017.234

Tuberculosis in patients older than 80 years at a high-complexity institution

Tuberculosis en pacientes mayores de 80 años atendidos en una institución de alta complejidad

Published 2017-08-01

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Vol. 29 No. 1 (2017)

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Research article

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Tuberculosis in patients older than 80 years at a high-complexity institution. rev. colomb. neumol. [Internet]. 2017 Aug. 1 [cited 2024 Nov. 16];29(1):19-25. Available from: https://revistas.asoneumocito.org/index.php/rcneumologia/article/view/234

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https://doi.org/10.30789/rcneumologia.v29.n1.2017.234

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José Fernando García-Goez

Servicio de Infectologia,Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia. Estudiante de Medicina. Programa de Medicina, Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia.

Hernán Esteban Munévar

Centro de Investigaciones Clínicas - Cali

Robinson Pacheco

Centro de Investigaciones Clínicas - Cali

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José Fernando García-Goez,

Servicio de Infectologia, Centro de Investigaciones Clínicas Fundación Valle del Lili, Estudiante de Medicina. Programa de Medicina, Facultad de Ciencias de la Salud, Universidad ICESICali, Colombia.

Hernán Esteban Munévar,

Estudiante de Medicina. Programa de Medicina, Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia.

Robinson Pacheco,

Centro de Investigaciones Clínicas, Fundación Valle del Lili, Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia

older patient

octogenarian

tuberculosis

antituberculous

Introduction: people older than 80 years are vulnerable to the development of tuberculosis; this is due to immunosenescence, comorbidities, malnutrition, and sedentariness, which predispose to primary infection or reactivation of latent infection. Its clinical presentation is unusual. Treatment of tuberculosis is difficult due to adverse events and drug interactions. Objective: to describe the clinical and microbiological characteristics and the most common outcomes of patients older than 80 years diagnosed with tuberculosis. Materials and methods: retrospective cohort study of patients older than 80 years diagnosed with tuberculosis. Information (clinical, microbiological, radiological, and regarding outcomes and response to treatment) from the institutional tuberculosis database was collected and analyzed. Results: between 2011 and 2016, 27 patients older than 80 years were diagnosed with tuberculosis. The median age was 84 years (IR 80-91); the following risk factors for this disease were identified: chronic obstructive pulmonary disease in 37%, tobacco use in 26%, diabetes in 11%, cancer in 11%, and previous infection by tuberculosis in 7%. Diagnosis was delayed (>30 days) in 74%. The sites of infection were: 52% pulmonary, 26% extrapulmonary, and 22% mixed. Of the patients with pulmonary involvement, 41% had positive sputum examinations and 50% had lung cavitations on chest radiographs. After treatment, tuberculosis was reported to be cured in 37%, death was reported in 15%, and follow-up was lost in 37%. Conclusions: there is evidence of delayed diagnosis, due to the fact that clinical and radiological presentation of tuberculosis in this age group is unusual with regard to the general population. Extrapulmonary tuberculosis was more common in older patients. The low rates of successful treatment, the high percentage of mortality, and the loss of follow-up are a challenge for the healthcare systems and professionals.

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