Comparison of newly diagnosed young and elderly tuberculous patients

Abstract

In this study, young (between 15 and 40 years of age) patients (group 1) and elderly (≥60 years of age) patients (group 2) with tuberculosis who were followed and treated in our dispensary between 1990 and 2002 were evaluated retrospectively. This study included 327 young adults (81.3%) and 75 elderly patients (18.7%) who had diagnoses of tuberculosis microbiologically and histopathologically. The mean ages were 26.1±5.3 and 67.6±6.3 years, respectively. The rates of pulmonary (77.1% and 76.0%) and extrapulmonary (22.9% and 24.0%) tuberculosis were similar (p>0.05). The patients’ symptoms were not different in both groups. But comorbidity was higher in group 2 (p<0.001). The common radiographic findings were infiltration (47.1% and 57.3%, p<0.05), cavity (7.3% and 4.0%, p>0.05), cavity and infiltration (20.8% and 16.0%, p>0.05). Smear positivity was similar in both groups (67.6% and 71.2%, p>0.05). There were no differences between the two groups according to disappearance of bacilli in smears and culture (p>0.05). According to treatment results, the rates of discontinuation of therapy (3.9% and 8.0%) and mortality (0.6% and 4.0%) were higher (p<0.001), but successful treatment (95.5% and 88.0%) rates were lower in group 2 than in group 1 (p>0.05). As a result, there were no differences between group 1 and group 2 with respect to clinical and laboratory findings. But the mortality and unsuccessful treatment rates were higher in elderly patients. For this reason, elderly tuberculosis patients must be followed and treated carefully.

Özet

Dispanserimizde 1990 ve 2002 tarihleri arasında tüberküloz tanısıyla takip ve tedavi edilen 15-40 yaş arası (grup 1) ve 60 yaş üstü (grup 2) vakaların özellikleri retrospektif olarak incelendi. Çalışmaya mikrobiyolojik ve histopatolojik olarak tanı konulmuş 327 genç (%81.3), 75 yaşlı (%18.7) hasta dahil edildi. Ortalama yaş sırasıyla 26.1±5.3 ve 67.6±6.3 yıldı. Akciğer (%77.1 ve %76.0) ve akciğer dışı (%22.9 ve %24.0) tüberküloz oranları her iki grupta benzerdi (p>0.05). Semptomlar her iki grupta da benzer bulundu. Ek hastalık oranı yaşlı grupta daha yüksekti (p 0.05). Yayma pozitiflik oranları (%67.6 ve %71.2) ile yayma ve kültürün negatifleşme zamanları arasında anlamlı bir farklılık saptanmadı (p>0.05). Ancak tedavi sonuçları değerlendirildiğinde, tedaviyi terk (%3.9 ve %8.0) ve ölüm (%0.6 ve %4.0) oranlarının yaşlılarda daha yüksek (p 0.05). Sonuç olarak genç ve yaşlı tüberkülozlu olgularda klinik ve laboratuvar bulguları açısından bir farklılık olmadığı, ancak tedaviyi terk ve ölüm oranlarının yaşlılarda fazla olması nedeniyle, bu hastaların takip ve tedavilerinin daha dikkatli yapılması gerektiği sonucuna varıldı.