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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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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
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author Fernando García-Goez, Jose
Diego Velez, Juan
Pino-Escobar, Jessica
Lucía Mora, Barbara
Parra-Lara, Luis Gabriel
Caylà, Joan A
Miró, José M
author_facet Fernando García-Goez, Jose
Diego Velez, Juan
Pino-Escobar, Jessica
Lucía Mora, Barbara
Parra-Lara, Luis Gabriel
Caylà, Joan A
Miró, José M
author_sort Fernando García-Goez, Jose
collection PubMed
description 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.
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spelling pubmed-68093812019-10-28 1368. Tuberculosis in Older Patients in Cali, Colombia (2011–2016): A Hospital-Based Cohort Study Fernando García-Goez, Jose Diego Velez, Juan Pino-Escobar, Jessica Lucía Mora, Barbara Parra-Lara, Luis Gabriel Caylà, Joan A Miró, José M Open Forum Infect Dis Abstracts 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. Oxford University Press 2019-10-23 /pmc/articles/PMC6809381/ http://dx.doi.org/10.1093/ofid/ofz360.1232 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Fernando García-Goez, Jose
Diego Velez, Juan
Pino-Escobar, Jessica
Lucía Mora, Barbara
Parra-Lara, Luis Gabriel
Caylà, Joan A
Miró, José M
1368. Tuberculosis in Older Patients in Cali, Colombia (2011–2016): A Hospital-Based Cohort Study
title 1368. Tuberculosis in Older Patients in Cali, Colombia (2011–2016): A Hospital-Based Cohort Study
title_full 1368. Tuberculosis in Older Patients in Cali, Colombia (2011–2016): A Hospital-Based Cohort Study
title_fullStr 1368. Tuberculosis in Older Patients in Cali, Colombia (2011–2016): A Hospital-Based Cohort Study
title_full_unstemmed 1368. Tuberculosis in Older Patients in Cali, Colombia (2011–2016): A Hospital-Based Cohort Study
title_short 1368. Tuberculosis in Older Patients in Cali, Colombia (2011–2016): A Hospital-Based Cohort Study
title_sort 1368. tuberculosis in older patients in cali, colombia (2011–2016): a hospital-based cohort study
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809381/
http://dx.doi.org/10.1093/ofid/ofz360.1232
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