Tuberc Respir Dis TRD Tuberculosis and Respiratory Diseases 1738-3536 2005-6184 The Korean Academy of Tuberculosis and Respiratory Diseases 10.4046/trd.2010.69.3.163 Original Article Characteristics of Pulmonary Tuberculosis in Elderly People Shin Ji Young M.D. Jung Sun Young M.D. Lee Jeong Eun M.D. Park Ji Won M.D. Yoo Su Jin M.D. Park Hee Sun M.D. Kim Ju Ock M.D. Kim Sun Young M.D. Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea. Address for correspondence: Sun Young Kim, M.D. Department of Internal Medicine, Chungnam National University Hospital, 640, Daesa-dong, Jung-gu, Daejeon 301-721, Korea. Phone: 82-42-280-7154, Fax: 82-42-257-5753, sykim@cnu.ac.kr

Ji Young Shin and Sun Young Jung contributed equally to this work.

 09 2010 30 09 2010 69 3 163 170 28 06 2010 05 08 2010 Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved. 2010 Background

Pulmonary tuberculosis remains a health concern in Korea despite major progress in the development of new strategies for diagnosing and treating tuberculosis. In particular, the diagnosis of newly developed pulmonary tuberculosis is on the rise in elderly persons. The aim of this study was to investigate the clinical, radiographic characteristics, and treatment outcomes of pulm onary tuberculosis in the elderly.

 Methods

The medical records of 113 young (<65 years old) and 112 elderly (≥65 years old) pulmonary tuberculosis patients diagnosed at Chungnam National University hospital between January 2007 and December 2008 were reviewed.

 Results

There was no difference in the prevalence of typical symptoms between the younger and the elderly group. Dypsnea was the only symptom that occurred more frequently in the elderly group (16.8% vs 5.5%, p=0.008). On radiological study, pneumonic infiltration type was more common in the elderly group (28.6% vs 16.8%, p=0.035). Sputum Acid fast bacilli smear positivity rate was similar between the 2 groups. Elderly patients with anti-tuberculosis medication had more frequent adverse drug reactions; however, there was no significant difference between the 2 groups in the number of patients required to stop medication due to an adverse drug reaction. There were more patients lost to follow-up in the elderly group (22/112, 19.6% vs 11/113, 9.7%, p=0.036).

 Conclusion

The majority of elderly patients did not complete the treatment, resulting in a poorer outcome. Therefore, we need to make an effort to support the continued screening of elderly patients by making this economically feasible.

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Age associated decrease in percentage of cure rates in pulmonary tuberculosis (p=0.033).

Initial presenting symptoms in young and elderly patients with pulmonary tuberculosis

*p<0.05.

Coexisting medical disease in young and elderly patients with pulmonary tuberculosis

*p<0.05.

The initial presenting chest radiograph findings in young and elderly patients with pulmonary tuberculosis*

*Lesion of the Upper lobe only or upper lobe plus other lobe, †p<0.05.

Comparison of diagnostic tool in young and elderly patients with pulmonary tuberculosis

*Bronchoscopy was performed for 88 patients in younger group and 79 patients in elderly group, †p<0.05.

Bronchoscopic finding in young and elderly patients with pulmonary tuberculosis

*p<0.05.

Comparison of adverse drug reactions experienced by young and elderly patients with pulmonary tuberculosis

*p<0.05.

Outcomes of treatment for young and elderly patients with pulmonary tuberculosis

*p<0.05.