Cargando…
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...
Autores principales: | , , , , , , |
---|---|
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 |
_version_ | 1783461973817556992 |
---|---|
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. |
format | Online Article Text |
id | pubmed-6809381 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT fernandogarciagoezjose 1368tuberculosisinolderpatientsincalicolombia20112016ahospitalbasedcohortstudy AT diegovelezjuan 1368tuberculosisinolderpatientsincalicolombia20112016ahospitalbasedcohortstudy AT pinoescobarjessica 1368tuberculosisinolderpatientsincalicolombia20112016ahospitalbasedcohortstudy AT luciamorabarbara 1368tuberculosisinolderpatientsincalicolombia20112016ahospitalbasedcohortstudy AT parralaraluisgabriel 1368tuberculosisinolderpatientsincalicolombia20112016ahospitalbasedcohortstudy AT caylajoana 1368tuberculosisinolderpatientsincalicolombia20112016ahospitalbasedcohortstudy AT mirojosem 1368tuberculosisinolderpatientsincalicolombia20112016ahospitalbasedcohortstudy |