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1368. Tuberculosis in Older Patients in Cali, Colombia (2011–2016): A Hospital-Based Cohort Study

BACKGROUND: Tuberculosis (TB) in older adults is a public health concern worldwide. We aim to describe the outcomes of patients over 65 years old with a confirmed TB diagnosis. We furthermore assessed factors related to poor outcomes among this patient population. METHODS: This retrospective study i...

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Detalles Bibliográficos
Autores principales: Fernando García-Goez, Jose, Diego Velez, Juan, Pino-Escobar, Jessica, Lucía Mora, Barbara, Parra-Lara, Luis Gabriel, Caylà, Joan A, Miró, José M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809381/
http://dx.doi.org/10.1093/ofid/ofz360.1232
Descripción
Sumario:BACKGROUND: Tuberculosis (TB) in older adults is a public health concern worldwide. We aim to describe the outcomes of patients over 65 years old with a confirmed TB diagnosis. We furthermore assessed factors related to poor outcomes among this patient population. METHODS: This retrospective study included patients older than 65 years with a biological specimen positive by smear microscopy, culture, or GeneXpert. Clinical and microbiological data, information about drug-related side effects, adverse reactions, and TB treatment outcomes were reviewed. Patients were subsequently assigned to either the octogenarian group or non-octogenarian group, also the treatment success group or treatment nonsuccess group. RESULTS: A total of 108 patients were included. 59% were male, and 26% of patients were 80 years old or older. 81% of the patients presented pulmonary TB. Diagnostic delay greater than 90 days was present in 36% of the cases. There was a statistically significant difference in the rates of diabetes (P = 0.004) and COPD (P = 0.017) between the octogenarian group and non-octogenarian group. One hundred six patients started anti-TB therapy, 34% of cases were lost to follow-up, and 18% died. Patients of 65–79 years of age and those older than 80 years had similar mortality, 19% vs. 18%, respectively. When comparing treatment success (n = 45) and nonsuccess (n = 22) groups, most of the variables were found not to be statistically significant as TB risk factors, except malignancy (P = 0.013). Overall, survival of the patients was 78. 23% at 5 years follow-up; there were no differences between age groups. CONCLUSION: The presence of baseline comorbidities as diabetes, malignancies and COPD, diagnosis delay, adverse events during anti-TB treatment and drug–drug interactions (DDI) makes this age group a different population, hence care models need to be evaluated to improve the indicators of the success of TB programs. Furthermore, the significant losses to follow-up require strict management of these patients and optimal coordination among health centers. DISCLOSURES: All authors: No reported disclosures.