TRENDS IN MORTALITY FROM TUBERCULOSIS IN ENGLAND AND WALES - EFFECT OF AGE ON DEATHS FROM NON-RESPIRATORY DISEASE
TRENDS IN MORTALITY FROM TUBERCULOSIS IN ENGLAND AND WALES - EFFECT OF AGE ON DEATHS FROM NON-RESPIRATORY DISEASE
复制标题
DOI：
10.1136/thx.50.9.976
复制
发表时间：
1995-09-01
期刊：
影响因子：
10
通讯作者：
DAVIES, PDO
中科院分区：
文献类型：
--
作者：
DOHERTY, MJ;SPENCE, DPS;DAVIES, PDO
背景--尽管近年来结核病死亡率持续下降，但同期结核病病死率变化不大。以前的研究表明，这是由于老年人患结核病的比例越来越高。结核病死亡率和病死率，因此进行了分析，以确定这种令人失望的趋势，病死率已发生的疾病在所有或只有某些sites.Methods -一个回顾性分析的结核病死亡率和病死率在英格兰和威尔士的1972-92年期间进行。结核病的平均年百分比变化计算每个疾病部位和年龄组和结果进行了compared.Results -分析表明，虽然死亡率稳步下降5。6%，病死率仅下降0。9%（95% CI-1.七比零1)每年。呼吸系统和中枢神经系统疾病的病死率下降，但“其他"部位的结核病没有下降（1。01%（升2. 2比-0 2)所有年龄组的总和）。然而，在75岁及以上年龄组中，其他地点因疾病死亡的比例增加了3。2%（2 . 2比4 3)每年，而在其他年龄组的死亡率下降。Conclusions -这项分析表明，临床医生可能越来越不能认识到非呼吸道结核病的介绍，特别是在老年人，并强调需要考虑结核病的诊断，以避免延误治疗。
Background - Although mortality from tuberculosis has continued to fall in recent years, there has been little change in the case fatality rate for tuberculosis over the same period. This has previously been shown to be due to the increasing proportion of cases of tuberculosis occurring in the elderly. Tuberculosis mortality and case fatality were therefore analysed to determine if this disappointing trend in case fatality rate has occurred from disease in all or only certain sites.Methods - A retrospective analysis of the tuberculosis mortality and case fatality rates in England and Wales for the period 1972-92 was carried out. The average annual percentage change in tuberculosis was calculated for each disease site and by age group and the results were compared.Results - The analysis showed that, although the mortality rate fell steadily by 5 . 6% per annum, the case fatality rate decreased by only 0 . 9% (95% CI -1 . 7 to -0 . 1) per annum. The case fatality rate for respiratory and central nervous system disease declined, but no decline in tuberculosis at ''other'' sites was observed (1 . 01% (+2 . 2 to -0 . 2) for all age groups combined). In the group aged 75 and over, however, the proportion of deaths due to disease at other sites increased by 3 . 2% (2 . 2 to 4 . 3) per annum whilst in the other age groups the mortality rate declined.Conclusions - This analysis suggests that clinicians may be becoming less able to recognise non-respiratory presentations of tuberculosis, particularly in the elderly, and underlines the need to consider tuberculosis as a diagnosis to avoid delay in treatment.