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Journal of the American Geriatrics Society

Mortality of Tuberculosis in Very Old People

Authors

  • Meritxell Salvadó MD,

    1. From the Departments of *Internal Medicine, Infectious Disease, Epidemiology, and §Microbiology Services, Hospital Universitari Mútua de Terrassa and Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
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  • Carolina Garcia-Vidal MD,

    1. From the Departments of *Internal Medicine, Infectious Disease, Epidemiology, and §Microbiology Services, Hospital Universitari Mútua de Terrassa and Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
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  • Pilar Vázquez MD,

    1. From the Departments of *Internal Medicine, Infectious Disease, Epidemiology, and §Microbiology Services, Hospital Universitari Mútua de Terrassa and Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
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  • Montserrat Riera NR,

    1. From the Departments of *Internal Medicine, Infectious Disease, Epidemiology, and §Microbiology Services, Hospital Universitari Mútua de Terrassa and Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
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  • Mónica Rodríguez-Carballeira MD, PhD,

    1. From the Departments of *Internal Medicine, Infectious Disease, Epidemiology, and §Microbiology Services, Hospital Universitari Mútua de Terrassa and Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
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  • Javier Martínez-Lacasa MD, PhD,

    1. From the Departments of *Internal Medicine, Infectious Disease, Epidemiology, and §Microbiology Services, Hospital Universitari Mútua de Terrassa and Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
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  • Eva Cuchi MD,

    1. From the Departments of *Internal Medicine, Infectious Disease, Epidemiology, and §Microbiology Services, Hospital Universitari Mútua de Terrassa and Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
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  • Javier Garau MD, PhD

    1. From the Departments of *Internal Medicine, Infectious Disease, Epidemiology, and §Microbiology Services, Hospital Universitari Mútua de Terrassa and Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
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Address correspondence to Carolina Garcia-Vidal, Infectious Disease Service, Hospital de Bellvitge, Feixa Llarga s/n, 08907 L'Hospitalet, Barcelona, Spain. E-mail: carolgv75@hotmail.com

Abstract

OBJECTIVES: To describe the clinical characteristics and outcomes of tuberculosis (TB) in elderly people.

DESIGN: Observational analysis of a prospective cohort of adults with TB (1995–2004). A case–control study to determine attributable mortality to TB in very old people was done.

RESULTS: Of 319 patients with TB, 109 (34.2%) were aged 65 and older. The older group was more likely to have comorbidities (1.4% vs 0.4%; P<.001), extrapulmonary and disseminated TB (50.4% vs 26.1%; P<.001), toxicity (22% vs 9.8%; P=.006), and 30-day mortality (18.3% vs 1.6%; P<.001). When patients aged 65 to 79 were compared with those aged 80 and older, only differences in TB-related mortality were detected (9.8% vs 44.4%; P=.01). In the attributable mortality analysis, 30-day and 6-month mortality were higher in very old patients with TB than in controls without TB (41.7% vs 11.1%, P=.005; 45.8% and 19.4%, P=.01, respectively). No differences in mortality were shown when excluding patients with postmortem TB diagnosis or those who died within the first 72 hours of diagnosis.

CONCLUSION: Older people with TB had a higher frequency of atypical features, more adverse drug reactions, and greater TB-related mortality than younger people. Data suggest that very old patients with TB have higher mortality, but if diagnosed early and adequately treated, very old patients with TB do not have greater mortality than those without.

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