TUBERCULOSIS IN THE AUTOPSY MATERIAL - ANALYSIS OF 1500 AUTOPSIES PERFORMED BETWEEN 1972 AND 1991 IN THE INSTITUTE OF TUBERCULOSIS AND CHEST DISEASES, WARSAW, POLAND
TUBERCULOSIS IN THE AUTOPSY MATERIAL - ANALYSIS OF 1500 AUTOPSIES PERFORMED BETWEEN 1972 AND 1991 IN THE INSTITUTE OF TUBERCULOSIS AND CHEST DISEASES, WARSAW, POLAND
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DOI：
10.1016/s0962-8479(05)80035-8
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发表时间：
1995-08-01
期刊：
影响因子：
--
通讯作者：
ZWOLSKAKWIEK, Z
中科院分区：
文献类型：
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作者：
ROWINSKAZAKRZEWSKA, E;SZOPINSKI, J;ZWOLSKAKWIEK, Z
设定：本研究是根据波兰华沙结核和胸部疾病研究所1972-81和1982- 91年的1500例尸检资料进行的。目的：评价上述时间段内死亡前结核病诊断的正确性。结核病的形式和定位进行了评估。尸检诊断与临床诊断进行比较。结果：119例尸检中发现活动性肺结核，占7.9%。72例仅局限于肺部，45例局限于肺部和肺外部位，仅2例局限于肺外部位。活动性肺结核的发病率在两个评价期内相同。然而，在1982- 1991年，结核病在死亡前没有被发现的比例（54%）比1972- 1981年（24%）高得多。诊断失败的主要原因是与胸部X线上病变的非典型定位和肺外扩散有关。以前的结核病是一个因素，促进了结核病的诊断。结论：在平行结核病发病率的下降，在波兰，许多医生缺乏经验，在诊断这种疾病，特别是在不典型的X线表现和肺外定位的情况下。这可能会导致迟发或甚至很晚的诊断，并对流行病学情况产生重大影响。
Setting: The present study is based on 1500 autopies done in the Institute of Tuberculosis and Chest Diseases Warsaw, Poland during the years 1972-81 and 1982-91.Objective: To assess the correctness of tuberculosis diagnosis before death in the above mentioned time periods.Design: The autopsy reports were examined for the diagnosis of active tuberculosis proved by microscopy. The form and localisation of tuberculosis was assessed. The postmortem diagnosis was compared with clinical diagnosis. In those cases in which tuberculosis was not recognised before death the possible causes of this failure were analyzed.Results: Active tuberculosis was found in 119 cases, 7.9% of all autopsies. It was localised in the lungs exclusively in 72 cases, in lungs and in extrapulmonary sites in 45 and in extrapulmonary sites only in 2. The frequency of active tuberculosis was the same for the two periods under evaluation. Tuberculosis was however not recognised before death in a much higher proportion of cases in 1982-91 (54%) than in 1972-81 (24%). The main cause of diagnostic failure was connected with atypical localisation of lesions on chest X-ray and with dissemination outside the lungs. Previous tuberculosis was a factor which facilitated the diagnosis of tuberculosis.Conclusion: In parallel with the decline of tuberculosis incidence in Poland, many doctors lack experience in diagnosing this disease, especially in cases with atypical X-ray presentation and with extrapulmonary localisation. This may lead to late or even very late diagnosis and have a significant impact on the epidemiological situation.