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Vol. 219. Issue 7.
Pages 390-393 (October 2019)
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Vol. 219. Issue 7.
Pages 390-393 (October 2019)
Brief Original
Missed opportunities for detecting tuberculosis: An analysis of emergency department visits before the diagnosis
Oportunidades perdidas en la detección de la tuberculosis: análisis de las visitas a Urgencias antes del diagnóstico
E. Nofuentes-Péreza,c, L. Zamora-Molinaa, J. Grau-Delgadoa, M.J. Soler-Semperea, J.A. Gutiérrez-Navarrob, E. García-Pachóna,c,
Corresponding author
eduardo.garciap@umh.es

Corresponding author.
a Sección de Neumología, Hospital General Universitario de Elche, Elche, Alicante, Spain
b Servicio de Urgencias, Hospital General Universitario de Elche, Elche, Alicante, Spain
c Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Alicante, Spain
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Table 1. Characteristics of patients with a final diagnosis of tuberculosis in previous visits to the emergency department.
Abstract
Objective

To assess the frequency of care in an emergency department in the 6 months prior to the diagnosis of tuberculosis and to determine the reasons for the care, the degree of suspicion in the emergency department and the factors associated with this suspicion.

Method

A retrospective study was conducted on patients with pulmonary tuberculosis treated in the general emergency department between 2011 and 2017.

Results

Of the 54 included patients, 38 (70%) had been treated in the emergency department in the 6 months prior to the diagnosis: 6 (16%) patients had been treated for processes unrelated to the tuberculosis, and 32 (84%) were treated for processes that were potentially related to the tuberculosis. Pulmonary tuberculosis was suspected in the emergency department for 12 (38%) of these patients and not suspected in the remaining 20 patients (62%). The group in which pulmonary tuberculosis was suspected had a higher rate of general and respiratory symptoms and cavitation in the radiography.

Conclusions

A high percentage of patients with pulmonary tuberculosis were admitted to the emergency department in the 6 months prior to the diagnosis, and this diagnostic possibility was often not suspected.

Keywords:
Diagnosis
Emergency department
Pulmonary tuberculosis
Resumen
Objetivo

Evaluar en pacientes diagnosticados de tuberculosis pulmonar la frecuencia de asistencias en Urgencias en los 6 meses previos al diagnóstico, conocer los motivos de la asistencia, el grado de sospecha en Urgencias y los factores a los que se asociaba esta sospecha.

Método

Estudio retrospectivo de los casos de tuberculosis pulmonar atendidos en un servicio de Urgencias generales entre 2011 y 2017.

Resultados

De los 54 pacientes incluidos, 38 (70%) habían sido atendidos en el servicio de Urgencias en los 6 meses previos al diagnóstico: 6 (16%) por procesos sin relación con la tuberculosis y 32 (84%) con relación potencial. En 12 (38%) de estos pacientes se sospechó en Urgencias la posibilidad del diagnóstico de tuberculosis pulmonar, y no se sospechó en los restantes 20 pacientes (62%). El grupo en el que se sospechó tenía más frecuencia de síntomas generales y respiratorios y más frecuencia de cavitación en la radiografía.

Conclusiones

Un elevado porcentaje de pacientes con tuberculosis pulmonar han consultado en Urgencias en los 6 meses previos al diagnóstico, y con mucha frecuencia esta posibilidad diagnóstica no se sospecha.

Palabras clave:
Diagnóstico
Servicio de urgencias
Tuberculosis pulmonar

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