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Characteristics and risk factors associated with missed diagnosis in patients with smear-negative pulmonary tuberculosis

Authors
 Se Hyun Kwak  ;  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 
Citation
 KOREAN JOURNAL OF INTERNAL MEDICINE, Vol.36(Suppl 1) : S151-S159, 2021-03 
Journal Title
 KOREAN JOURNAL OF INTERNAL MEDICINE 
ISSN
 1226-3303 
Issue Date
2021-03
Keywords
Diagnosis ; Lung disease ; Risk factors ; Tuberculosis
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. Conclusion: 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.
DOI
10.3904/kjim.2019.435
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Kwak, Se Hyun(곽세현)
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Lee, Sang Hoon(이상훈) ORCID logo https://orcid.org/0000-0002-7706-5318
Lee, Su Hwan(이수환) ORCID logo https://orcid.org/0000-0002-3487-2574
Lee, Eun Hye(이은혜) ORCID logo https://orcid.org/0000-0003-2570-3442
Leem, Ah Young(임아영) ORCID logo https://orcid.org/0000-0001-5165-3704
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Jung, Kyung Soo(정경수) ORCID logo https://orcid.org/0000-0003-1604-8730
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
Choi, Ji Soo(최지수) ORCID logo https://orcid.org/0000-0003-2716-6775
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182326
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