Clinical and evolutif characteristics of pulmonary tuberculosis in elderly patients

Abstract

<b>Introduction:</b> Diagnosis of pulmonary tuberculosis (PTB) is more complex in hospitalized eldery patients. <b>Aims:</b> To compare characteristics of PTB in elderly patients versus young patients. <b>Methods:</b> A retrospective study was carried out at the respiratory department of Charles Nicolle hospital in Tunisia from January 2018 to December 2020. Adult patients with diagnosis of PTB were included. Two groups were identified : G1 patients aged &gt; 65 years and G2 patients aged ≤ 65 years. <b>Results:</b> We included 85 patients (G1=18 patients and G2= 67 patients). The median age of G1 was 71.4 ± 6.4 years vs 39 ± 14 years for G2. There was no significant difference in comorbidities between the two groups. General symptoms (anorexia, fatigue and loss of weight) were more reported by elderly patients (p = 0.02). Whereas, hemoptysis was more commun in young patients (p = 0.01). Time to consultation was longer in eldery patients (68 ± 44 days vs 51 ± 39 days, p=0.036). Chest X-ray showed Cavitary lesions and pleural images which were more frequent in G2(p= 0.026 and p = 0.035 respectively). The diagnosis was retained by bacteriological sampling in all cases and time to confirmation was similar in the two groups. Hospital stay was longer in eldery patients (p=0.03) and we deplored 5 deaths in G1 and 3 deaths in G2. <b>Conclusions:</b> Pulmonary tuberculosis in elderly patients is caracterized by general and non-specific symptoms causing a delay in diagnosis and a longer hospital stay.