- 期刊
肺結核住院病人死亡之相關因素
The Factors Affecting Inpatient Deaths from Tuberculosis
摘要
目的：肺結核是一種肺病發炎疾病並且可能因廣泛性肺部纖維化而導致死亡。本研究目的在分析台灣某地區醫院診斷為肺結核之死亡住院病人，其死亡原因分類與特徵。方法：利用2004年至2007年住院病歷、外院轉入之病歷摘要回顧及疾病管制局結核病登錄資料，共收集118名結核病死亡同時尚未完治的案例；結果：發現結核病死亡個案平均年齡為74.26歲、呼吸器使用率62.71%、查爾森既有疾病指標分數平均值1.89、胸部X光判讀重度有空洞肺結核佔48.70%、血清白蛋白平均值2.58g/dl（±0.59）、血紅素10.26g/dl（±2.12），進一步將這些死亡案例分成三組（結核病為直接死亡原因組、死亡原因合併有肺結核組、死亡原因與肺結核無關組）進行分析，該結核病為死亡原因合併有肺結核組的病人其痰液中的抗耐酸檢驗（+）比其他兩組有較多量的桿菌，結核病為直接死亡原因組的病人其胸部X光的肺部發炎比其他兩組較嚴重。結論：建議未來能針對住院死亡之肺結核病人進行完治者與死亡者的相關研究，以了解兩者間之差異。
並列摘要
Objectives: Tuberculosis is the infective disease of the lungs that may cause death as a result of diffuse fibrotic changes to the lungs. The purpose of this study was to analyze the classification and characteristics of death among inpatients at a referral regional hospital in Taiwan who had been diagnosed as suffering from tuberculosis. Methods: For the years 2004 to 2007, inpatient's charts were reviewed as well as transferred summaries and CDC login data, These were used to identify 118 patients who had died while infected with tuberculosis and before their treatment had been completed. Results: The mean age of the patients was 74.26 years and 62.71% had received mechanical ventilator support. These patients had a mean Charlson comorbidity index of 1.89, a mean serum albumin level of 2.58g/dl (±0.59) and a mean hemoglobin level of 10.26g/dl (±2.12). Among these individuals, 48.70% had far-advanced pulmonary tuberculosis with a cavity based on their chest X-ray interpretation. The patients with tuberculosis who died were further divided into three groups, namely tuberculosis directed death, tuberculosis combined death and tuberculosis non-relevant death. The group consisting of tuberculosis combined death cases, compared to the other groups, had more tuberculous bacilli in sputum acid-fast smears. The group consisting of tuberculosis direct death cases, compared to the other groups, showed more severe inflammatory reaction by chest X-ray. Conclusion: It is recommended that this study of inpatient tuberculosis mortality be expanded to include patients that have completed their tuberculosis treatment.