Mortality of Tuberculosis in Very Old People

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 58; no. 1; pp. 18 - 22
• Main Authors: Salvadó, Meritxell, Garcia-Vidal, Carolina, Vázquez, Pilar, Riera, Montserrat, Rodríguez-Carballeira, Mónica, Martínez-Lacasa, Javier, Cuchi, Eva, Garau, Javier
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.01.2010; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; attributable mortality; Bacterial diseases; Biological and medical sciences; Case-Control Studies; Data processing; Drugs; Epidemiology; Female; General aspects; Geriatrics; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Mortality; Mycobacterium; old; Older people; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Toxicity; Tuberculosis; Tuberculosis - mortality; Tuberculosis and atypical mycobacterial infections; very old; Young Adult; Human; Mortality; old; Mycobacterial infection; Epidemiology; Infection; Gerontology; Tuberculosis; attributable mortality; Bacteriosis; very old; Elderly; Geriatrics
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2009.02619.x

OBJECTIVES: To describe the clinical characteristics and outcomes of tuberculosis (TB) in elderly people. DESIGN: Observational analysis of a prospective cohort of adults with TB (1995–2004). A case–control study to determine attributable mortality to TB in very old people was done. RESULTS: Of 319 patients with TB, 109 (34.2%) were aged 65 and older. The older group was more likely to have comorbidities (1.4% vs 0.4%; P<.001), extrapulmonary and disseminated TB (50.4% vs 26.1%; P<.001), toxicity (22% vs 9.8%; P=.006), and 30‐day mortality (18.3% vs 1.6%; P<.001). When patients aged 65 to 79 were compared with those aged 80 and older, only differences in TB‐related mortality were detected (9.8% vs 44.4%; P=.01). In the attributable mortality analysis, 30‐day and 6‐month mortality were higher in very old patients with TB than in controls without TB (41.7% vs 11.1%, P=.005; 45.8% and 19.4%, P=.01, respectively). No differences in mortality were shown when excluding patients with postmortem TB diagnosis or those who died within the first 72 hours of diagnosis. CONCLUSION: Older people with TB had a higher frequency of atypical features, more adverse drug reactions, and greater TB‐related mortality than younger people. Data suggest that very old patients with TB have higher mortality, but if diagnosed early and adequately treated, very old patients with TB do not have greater mortality than those without.