Admission for tuberculosis to a university hospital

Abstract

Admission for tuberculosis to a university hospital* SANDRA APARECIDA RIBEIRO 1 , THAÍS NEMOTO MATSUI 2 Patients with active tuberculosis (Tb) may be admitted to a hospital for different conditions, and not have Tb as their main diagnosis. In this study, 141 inpatient Tb cases are analyzed, which were notified to the São Paulo Hospital Central Control of Infectious Diseases from August, 1999, through April, 2001, with identification of causes, risk factors, and hospitalization time. Sixty-three percent of the patients were males, and 37% were females, with a mean age of 38.1 years. Twenty-eight percent of them were smokers, 23% were alcoholics, and 17% were drug addicts. Previous tuberculosis was reported by 23% of the patients. Forty-two of them were HIV-positive. Fifty-four point six percent had pulmonary Tb, 67.5% of which were sputum-positive. Twenty-two percent of the patients presented side effects to the Tb treatment during hospitalization, the most frequent of which were drug-induced hepatitis (65.7%), and gastric intolerance (25.7%). Eight point five percent of the patients required intensive care for an average of 11 days, and 54% stayed in a ward with respiratory isolation. Death occurred in 17.7% of cases, in 52% of them as a consequence of Tb. On the average, the patients stayed at the hospital for 29 days, and in isolation (when necessary) for 18 days. Drug addicted and smoking patients had longer hospitalization times. This was not the case of HIV-positive or sputum-positive patients. (J Pneumol 2003;29(1): 9-14)

Frequency of tuberculin rate among workers of the Hospital Antônio Pedro

“…In the study population was predominantly male, consistent with the literature, although variant as the sex ratio, 1,7 to 3,5 men for every woman 13 .…”

Tuberculose grave com necessidade de internação em UTI

“…(12) In another study, also conducted in São Paulo, 6.5% of the hospital admissions for tuberculosis were due to acute respiratory failure, and ICU admission was required in 8.5% of the cases. (13) An analysis of the hospitalizations for tuberculosis at a university hospital in the city of Porto Alegre, Brazil, found that 16.7% of the 311 cases of tuberculosis required ICU admission and that 15.4% developed respiratory failure requiring MV. (14) Clinical, laboratory, and radiological presentation Among hospitalized patients with severe tuberculosis, the most common symptoms include fever, night sweats, weight loss, and cough.…”

Diferenças nas características clínicas e epidemiológicas entre os casos notificados por tuberculose na atenção primária e terciária

“…Quando a APS falha, seja pela dificuldade de acesso ao serviço de saúde ou pela falta de capacitação das equipes de saúde em identificar os sintomáticos respiratórios, um aumento no número de casos de TB diagnosticados nos hospitais é observado (9) . Um estudo realizado na cidade de Vitória-ES, em 2009, relacionado ao atraso no diagnóstico para tuberculose na atenção básica de saúde, verificou um atraso total de 110 dias (10) .…”

“…No presente estudo, apesar de se mostrar uma baixa testagem para o HIV nos dois níveis de atenção, observou-se uma predominância dos pacientes HIV positivos na ATS e uma necessidade de se aumentar a oferta da sorologia na APS. Em um estudo realizado na cidade de São Paulo-SP, a sorologia para HIV obteve resultado positivo em 42% dos pacientes internados em um hospital universitário (9) . Esse fato demonstra a maior gravidade no quadro clínico desses pacientes, devido ao seu estado de imunossuprimido, sendo necessária sua internação.…”