Gender differences in early suspicion of tuberculosis in hospitalized, high-risk patients during 4 epidemic years, 1987 to 1990.
Gender differences in early suspicion of tuberculosis in hospitalized, high-risk patients during 4 epidemic years, 1987 to 1990.
复制标题
1987年至1990年4个流行年中住院高危患者早期怀疑结核病的性别差异。
DOI：
10.1086/647601
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发表时间：
1997
影响因子：
4.5
通讯作者：
Bennett,CL
中科院分区：
文献类型：
--
作者：
Cegielski,JP;Goetz,MB;Jacobson,JM;Cohn,SE;Weinstein,RA;DeHovitz,JA;Bennett,CL
目的评估1987年至1990年期间，在人类免疫缺陷病毒（HIV）感染的肺部疾病患者住院的前2天内，医生怀疑结核病（TB）的程度。1987年至1990年，174例成人获得性免疫缺陷综合征患者出院时诊断为卡氏肺孢子虫肺炎。诊断一般是不知道在admission.ResultsPhysicians怀疑结核病在头2个住院日在1987年，这些患者的66%，这一比率稳步上升到74%，在1990年。然而，医生认为女性患者中结核病的程度在4年内从76%下降到71%。通过多元逻辑回归控制混杂变量，男性早期怀疑结核病的几率增加了1.8倍（比值比[OR]，1.8; 95%置信区间[CI 95]，1.4-2.4），但女性没有增加（OR，0.6; CI 95，0.2-1.9）。在这五个城市中，结核病的早期怀疑的几率增加最多的纽约市（OR，3.9; CI 95，2.0-7.9）。ConclusionsPhysicians认为，结核病在及时的方式越来越多的男性，但不是女性，高风险患者在结核病在美国复苏的第一年。医生必须意识到艾滋病毒和结核病流行病学的变化，以及他们的实践模式，以防止这种疾病的医院传播
ObjectivesTo assess the degree to which, from 1987 to 1990, physicians suspected tuberculosis (TB) in the first 2 hospital days in human immunodeficiency virus (HIV)-infected patients with pulmonary disease.DesignRetrospective cohort study.Setting96 hospitals in five US cities.Patients2,174 adult patients with acquired immunodeficiency syndrome discharged with a diagnosis of Pneumocystis carinii pneumonia from 1987 to 1990. The diagnosis generally was not known on admission.ResultsPhysicians suspected TB in the first 2 hospital days in 66% of these patients in 1987, a rate that increased steadily to 74% in 1990. However, the extent to which physicians considered TB among female patients decreased from 76% to 71% over the 4 years. Controlling for confounding variables by multiple logistic regression, the odds that TB would be suspected early increased 1.8-fold among men (odds ratio [OR], 1.8; 95% confidence interval [CI95], 1.4-2.4), but not in women (OR, 0.6; CI95, 0.2-1.9). Among the five cities, the odds of early suspicion of TB increased most in New York City (OR, 3.9; CI95, 2.0-7.9).ConclusionsPhysicians considered TB in a timely manner in an increasing majority of male, but not female, high-risk patients during the first years of TB resurgence in the United States. Physicians must be aware of the changing epidemiology of HIV and TB, as well as their practice patterns, to prevent nosocomial transmission of this disease