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He M, Yang X, Zhang Z, Liu Z. Impaired pulmonary function and associated factors in the elderly with tuberculosis on admission: a preliminary report. BMC Infect Dis 2023; 23:251. [PMID: 37076819 PMCID: PMC10116730 DOI: 10.1186/s12879-023-08183-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 03/20/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Pulmonary tuberculosis (TB) can impair pulmonary function (PF), especially in the elderly. The risk factors associated with the severity of PF impairment in the elderly with pulmonary TB remain unclear. Hence, this retrospective study aimed to address this issue to help improve the management of TB in the elderly population. METHODS From January 2019 to February 2022, the elderly who were admitted to our hospital for pulmonary TB and underwent PF testing were included in this analysis. The forced expiratory volume in one second percent of predicted (FEV1% predicted) and clinical characteristics were collected and analyzed retrospectively. The extent of impaired PF was then categorized based on the FEV1% predicted and classified as grade 1-5. Logistic regression analysis was used to analyze the risk factors for impaired PF. RESULTS A total of 249 patients who met the enrollment criteria were included in this analysis. According to the results of FEV1% predicted, all patients were classified as grade 1 (n = 37), grade 2 (n = 46), grade 3 (n = 55), grade 4 (n = 56), or grade 5 (n = 55). Statistical analysis showed that albumin (adjusted odds ratio (aOR) = 0.928, P = 0.013), body mass index (BMI) < 18.5 kg/m2 (aOR = 4.968, P = 0.046), lesion number ≥ 3 (aOR = 4.229, P < 0.001), male (aOR = 2.252, P = 0.009), respiratory disease (aOR = 1.669, P = 0.046), and cardiovascular disease (aOR = 2.489, P = 0.027) were related to the impairment of PF. CONCLUSIONS PF impairment is common in the elderly with pulmonary TB. The male sex, BMI < 18.5 kg/m2, lesion number ≥ 3, hypoproteinemia, and respiratory and cardiovascular comorbidities were identified as risk factors for significant PF impairment. Our findings highlight the risk factors associated with PF impairment, which may be helpful to improve the current management of pulmonary TB in the elderly to save their lung function.
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Affiliation(s)
- Meiyan He
- Department of Tuberculosis, Lishui Hospital of Traditional Chinese Medicine, Zhejiang University of Traditional Chinese Medicine, No. 800 Zhongshan Road, Liandu District, Lishui, Zhejiang Province, China
| | - Xiaoming Yang
- Department of Respiratory Diseases, Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui, 323000, China
| | - Zunjing Zhang
- Department of Tuberculosis, Lishui Hospital of Traditional Chinese Medicine, Zhejiang University of Traditional Chinese Medicine, No. 800 Zhongshan Road, Liandu District, Lishui, Zhejiang Province, China
| | - Zhongda Liu
- Department of Tuberculosis, Lishui Hospital of Traditional Chinese Medicine, Zhejiang University of Traditional Chinese Medicine, No. 800 Zhongshan Road, Liandu District, Lishui, Zhejiang Province, China.
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Zhao P, Chen L, Xie ZQ, Jian JY, Sun PP. Clinical significance of CA-125 in elderly patients with active pulmonary tuberculosis: A retrospective study. Saudi Med J 2022; 43:1217-1223. [PMID: 36379539 PMCID: PMC10043917 DOI: 10.15537/smj.2022.43.11.20220460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES To assess the clinical significance of serum CA-125 levels in elderly patients with pulmonary tuberculosis (PTB). METHODS We retrospectively analyzed 1613 participants-patients (aged ≥60 years) admitted to the Beijing Shijitan Hospital, Beijing, China from February 2015 to January 2021 and healthy participants, divided into 4 groups: PTB (group 1), pulmonary malignancies (group 2), pulmonary non-malignant diseases (group 3), and healthy participants (group 4). Data concerning demographics, physical examination findings, computed tomography, histopathological examination, and laboratory tests for Mycobacterium tuberculosis and serum CA-125 levels were collected and analyzed. RESULTS There were 720 healthy individuals and 893 patients in the study. The median levels and abnormal rates of CA-125 in groups 1 (42.5, 57.3%) and 2 (34.4, 49.5%) were higher than those in groups 3 (21.1, 29.2%) and 4 (8.6, 0.4%) (p<0.05). The ordinal logistic regression analysis model revealed significant associations between CA-125 levels and PTB (OR and 95% confidence interval [CI]: 2.749 (1.876-4.027)), hypoproteinemia [OR and 95% CI: 1.519 (1.114-2.070)], serous effusion [OR and 95% CI: 7.364 (5.346-10.143)], pulmonary malignancy [OR and 95% CI: 2.206 (1.518-3.204)], respiratory failure [OR and 95% CI: 3.216 (2.087-4.956)], and cor pulmonale [OR and 95% CI: 2.990 (1.282-6.973)]. CONCLUSION Although elevated CA-125 levels may serve as a potential marker for diagnosing PTB in the elderly, they are affected by multiple factors, including serous effusion. Hence, caution is warranted while using this marker.
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Affiliation(s)
- Ping Zhao
- From the Department of Clinical Laboratory (Zhao, Chen, Xie, Jian, Sun), Beijing Shijitan Hospital, Capital Medical University; and from Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics (Zhao, Chen, Xie, Jian, Sun), Beijing, China
| | - Liang Chen
- From the Department of Clinical Laboratory (Zhao, Chen, Xie, Jian, Sun), Beijing Shijitan Hospital, Capital Medical University; and from Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics (Zhao, Chen, Xie, Jian, Sun), Beijing, China
| | - Ze Q. Xie
- From the Department of Clinical Laboratory (Zhao, Chen, Xie, Jian, Sun), Beijing Shijitan Hospital, Capital Medical University; and from Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics (Zhao, Chen, Xie, Jian, Sun), Beijing, China
| | - Ji Y. Jian
- From the Department of Clinical Laboratory (Zhao, Chen, Xie, Jian, Sun), Beijing Shijitan Hospital, Capital Medical University; and from Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics (Zhao, Chen, Xie, Jian, Sun), Beijing, China
| | - Pan P. Sun
- From the Department of Clinical Laboratory (Zhao, Chen, Xie, Jian, Sun), Beijing Shijitan Hospital, Capital Medical University; and from Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics (Zhao, Chen, Xie, Jian, Sun), Beijing, China
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Alende-Castro V, Macía-Rodríguez C, Páez-Guillán E, García-Villafranca A. Miliary pattern, a classic pulmonary finding of tuberculosis disease. J Clin Tuberc Other Mycobact Dis 2020; 20:100179. [PMID: 32904186 PMCID: PMC7452224 DOI: 10.1016/j.jctube.2020.100179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction The increase in age of the population and in the use of immunosuppressive treatment makes tuberculosis (TB) with hematogenous or lymphatic dissemination a current problem. Methods We collected all the patients diagnosed with tuberculosis with miliary pulmonary pattern at the Santiago de Compostela University Teaching Hospital (NW Spain) from 1 January 2006 to 31 December 2015. Results A total of 27 patients were included, 70.4% women, with a median age of 69.0 years old. A cause of immunosuppression was observed only in 51.9% of patients. The majority of the cases (65.0%) presented pulmonary affectation. The most frequently isolated species was Mycobacterium tuberculosis (88.9%). Multiresistance to first-line antituberculosis drugs was observed only in 3.7%. 92.6% of the patients received treatment with Isoniazid, Rifampicin and Pyrazinamine, associated in 48.1% of them with Ethambutol. Two patients died during admission and there were no recurrences in the 2-years follow-up. Conclusions Miliary tuberculosis remains a current pathology. Most patients do not have a known cause of immunosuppression. The response to the typical treatment is usually good.
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Affiliation(s)
- Vanesa Alende-Castro
- Department of Internal Medicine, Hospital do Salnés, Rúa Hospital do Salnes, 30, 36619 Vilagarcía de Arousa, Pontevedra, Spain
| | | | - Emilio Páez-Guillán
- Department of Internal Medicine, Complexo Hospitalario Universitario de Santiago de Compostela, Travesia da Choupana s/n, Santiago de Compostela, A Coruña, Spain
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