当院における肺結核症の死因分析 [in Japanese] THE CAUSES OF DEATH IN PATIENTS WITH NON-MDR PULMONARY TUBERCULOSIS IN OUR HOSPITAL [in Japanese]
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We studied the causes of death in 295 patients (mean (SD) age 70.5±13.2y.o.) with active non-MDR pulmonary tuberculosis who died in our hospital between 1991 and 1999. A hundred and twenty eight patients (43.4%, group A) died of tuberculosis, while 167 patients (56.6%) of other accompanying diseases. In 46 patients of the latter (15.6%, group B), pulmonary tuberculosis gave an unfavorable impact on their clinical course. In these patients the extent of pulmonary tuberculosis on chest roentgenograph was similar with the remaining 121 patients who also died of the accompanying diseases (41.0%, group C) and was less severe than those of the group A patients. Their nutritional conditions measured by serum albumin and choline-esterase level on admission, however, were as low as those of the group A patients and distinctly worse than those of the group C patients. Most patients of groups A and B died within 3 months after admission, while less than half patients of group C died during the same period. The age frequency distribution of the patients in groups B and C had a single peak in the age group 70 to 89, while that in group A showed two peaks, one similar peak as in groups B and C, and another peak in the age group 50 to 59. The numbers of homeless patients, of the patients with extensive cavitary lesions, and of the patients who died of ARDS (Adult Respiratory Distress Syndrome) or severe pneumothorax in group A were the most also in the age group 50 to 59, indicating that the patients' delay in admitting to hospitals was the major cause of high motality in this age group.<BR>As to detailed causes of death in group A, patients died of respiratory failure (32 cases), emaciation (28cases), progression of pulmonary tuberculosis (20cases), ARDS (15cases), tuberculosis-related diseases such as pneumothorax, hemoptysis, and DIC (24 cases). In groups B and C patients died of organ failure (36cases), infectious diseases (33cases) and malignancy (30cases). The total number of died patients has increased, and the proportion of cases dying of ARDS and infectious diseases has increased statistically significantly recently.
Kekkaku(Tuberculosis) 76(1), 1-8, 2001-01-15
JAPANESE SOCIETY FOR TUBERCULOSIS