Predictors and outcomes of disseminated tuberculosis in an intermediate burden setting
| العنوان: | Predictors and outcomes of disseminated tuberculosis in an intermediate burden setting |
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| المؤلفون: | Leonor Almeida, António G. Castro, Angélica Ramos, Teresa Carvalho, Catarina Chaves, Nuno S. Osório, Fernando Rodrigues, Margarida Saraiva, João Tiago Guimarães, Leonor Meira, Rita Boaventura, Helder Novais Bastos, David Araújo |
| المساهمون: | Instituto de Investigação e Inovação em Saúde, Universidade do Minho |
| المصدر: | Pulmonology, Vol 25, Iss 6, Pp 320-327 (2019) Repositório Científico de Acesso Aberto de Portugal Repositório Científico de Acesso Aberto de Portugal (RCAAP) instacron:RCAAP |
| بيانات النشر: | Elsevier España, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, Disseminated tuberculosis, Cirrhosis, medicine.medical_treatment, Antitubercular Agents, HIV Infections, Tuberculosis, Miliary / etiology, HIV Infections / complications, 0302 clinical medicine, Risk Factors, Weight loss, Odds Ratio, Culture conversion, Portugal / epidemiology, 030212 general & internal medicine, Antitubercular Agents / therapeutic use, Outcome, Smoking / epidemiology, Incidence (epidemiology), Smoking, Immunosuppression, Middle Aged, 3. Good health, Tuberculosis, Miliary / epidemiology, Cohort, Regression Analysis, Female, medicine.symptom, Adult, Pulmonary and Respiratory Medicine, Tuberculosis, Miliary / diagnosis, medicine.medical_specialty, Tuberculosis, Tuberculosis, Miliary / drug therapy, Statistics, Nonparametric, Immunocompromised Host, 03 medical and health sciences, Internal medicine, Statistical significance, medicine, Humans, Aged, Mycobacterium tuberculosis / isolation & purification, Retrospective Studies, lcsh:RC705-779, Science & Technology, Chi-Square Distribution, Portugal, Tuberculosis, Miliary, business.industry, Mycobacterium tuberculosis, lcsh:Diseases of the respiratory system, medicine.disease, 030228 respiratory system, business |
| الوصف: | Setting: University-affiliated hospital located in Porto, North Portugal, an area with a low to intermediate incidence of tuberculosis (TB). Objective: To identify predictors and outcomes of disseminated TB (dTB). Design: A cohort of patients diagnosed with TB between 2007 and 2013 was retrospectively analysed. Patients with dTB criteria were characterized and compared to single organ TB cases. Factors independently associated with dTB were determined by multivariate logistic regression analysis. Results: A total of 744 patients were analysed, including 145 with dTB. Independent risk factors for dTB were pharmacological immunosuppression (OR 5.6, 95% CI 2.8–11.3), HIV infection (OR 5.1, 95% CI 3.1–8.3), chronic liver failure or cirrhosis (OR 2.3, 95% CI 1.4–4.1) and duration of symptoms (OR 2.3, 95% CI 1.4–3.8). Compared to single organ TB, the clinical presentation of dTB patients differed by the absence of haemoptysis (OR 3.2, 95% CI 1.3–8.4) and of dyspnoea (OR 1.9, 95% CI 1.2–3.1), presence of weight loss (OR 1.8, 95% CI 1.1–2.9), night sweats (OR 1.7, 95% CI 1.1–2.7) and bilateral lung involvement (OR 4.4, 95% CI 2.8–7.1). Mortality and time until culture conversion were higher for dTB patients, although not reaching statistical significance. Conclusion: Immunosuppressive conditions and chronic liver failure or cirrhosis were associated with increased risk of dTB. The haematogenous spread may be dependent on longer symptomatic disease and usually progresses with bilateral lung involvement. HNB acknowledges the receipt of research scholarships from Bolsa D. Manuel de Mello and the Portuguese Society for Pneumology. NSO acknowledges FCT IF/00474/2014. The MS lab is financed by FEDER --- Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020 --- Operational Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through FCT in the framework of the project ‘‘Institute for Research and Innovation in Health Sciences’’ (POCI-01-0145-FEDER-007274). |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 2531-0437 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9a28cbff6bb6b0adf97b4f0ba0aa5ca9 http://www.sciencedirect.com/science/article/pii/S2531043718301788 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....9a28cbff6bb6b0adf97b4f0ba0aa5ca9 |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 25310437 |
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