Characteristics and risk factors associated with missed diagnosis in patients with smear-negative pulmonary tuberculosis
- Author:
Se Hyun KWAK
1
;
Ji Soo CHOI
;
Eun Hye LEE
;
Su Hwan LEE
;
Ah Young LEEM
;
Sang Hoon LEE
;
Song Yee KIM
;
Kyung Soo CHUNG
;
Ji Ye JUNG
;
Moo Suk PARK
;
Young Sam KIM
;
Joon CHANG
;
Young Ae KANG
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2021;36(Suppl 1):S151-S159
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:Delayed diagnosis and treatment of smear-negative pulmonary tuberculosis (TB) are major concerns for TB control. We evaluated characteristics of patients with smear-negative pulmonary TB who received a delayed diagnosis and identified risk factors that may have contributed to this delay.
Methods:We reviewed medical records of patients with smear-negative culture-positive pulmonary TB treated at a tertiary care hospital in South Korea between January 2017 and December 2018. Patients who initiated anti-TB treatment after positive cultures were included in the missed TB group, and those who initiated empirical treatment before positive cultures were included in the control group.
Results:Of 220 patients included, 117 (53.2%) and 103 (46.8%) were in the missed TB and control groups, respectively. Patients in the missed TB group were older (p = 0.001) and had a higher mean body mass index (BMI) (p = 0.019). Comorbidities (66.9% vs. 46.6%, p = 0.003) and immunocompromised patients (33.1% vs. 20.4%, p = 0.035) were more common in the missed TB group than in the control group. Old age (odds ratio [OR], 1.030; 95% confidence interval [CI], 1.012 to 1.048; p = 0.001), high BMI (OR, 1.114; 95% CI, 1.004 to 1.237; p = 0.042), and negative polymerase chain reaction (PCR) results (OR, 9.551; 95% CI, 4.925 to 18.521; p < 0.001) were associated with delayed diagnosis.
Conclusions:In more than half of patients with smear-negative pulmonary TB, the diagnosis was delayed. Patients with delayed TB diagnosis were older, had higher BMI, and negative PCR results.
