Estudio del retraso diagnóstico de la tuberculosis pulmonar sintomática

Altet Gómez, M.N.; Alcaide Megías, J.; Canela Soler, J.; Milá Augé, C.; Jiménez Fuentes, M.A.; de Souza Galvao, M.L.; Solsona Peiró, J.

doi:10.1016/S0300-2896(03)75348-4

Archivos de Bronconeumología

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Vol. 39. Issue 4.

Pages 146-152 (April 2003)

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Pages 146-152 (April 2003)

DOI: 10.1016/S0300-2896(03)75348-4

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Estudio del retraso diagnóstico de la tuberculosis pulmonar sintomática

Pulmonary symptomatic tuberculosis' diagnostic delay study

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M.N. Altet Gómeza,

Corresponding author

med025494@saludalia.com

Correspondencia: Unidad de Enfermedades del Tórax. Avda. de les Drassanes, 17-21. 08001 Barcelona. España

, J. Alcaide Megíasa, J. Canela Solerb, C. Milá Augéa, M.A. Jiménez Fuentesa, M.L. de Souza Galvaoa, J. Solsona Peiróa

a Unidad de Enfermedades del Tórax. Barcelona

b Cátedra de Bioestadística. Universidad de Barcelona. Barcelona. España

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Objetivo

Estudiar el retraso diagnóstico de la tuberculo-sis pulmonar (TBP) sintomática

Pacientes Y Métodos

Estudio prospectivo de casos nuevos sintomáticos de TBP (edad = 15 años) mediante entrevista estructurada al paciente y su familia. Las variables fundamentales analizadas fueron: retraso del enfermo (RE), retraso atribuible al médico (RM), retraso durante el proceso diagnóstico (RPD), retraso en el sistema sanitario (RSS) y retraso total (RT), esto es, el tiempo transcurrido desde el comienzo de los síntomas hasta el inicio del tratamiento de la TBP. Se realizó un análisis estadístico univariante, así como análisis multivariante para cada uno de los componentes del retraso diagnóstico

Resultados

Se estudió a 287 enfermos. La media en días ± desviación estándar (DE) fue para el RT y sus distintos componentes de 81,8 ± 77,3 en el RT, 43,3 ± 55,7 días en el RE, de 28,4 ± 59,6 días en el RM; para el RD, de 10,0 ± 17,7 días y en el RSS de 38,5 ± 62,5 días

Conclusiones

Dentro del elevado retraso diagnóstico de la TBP los enfermos son responsables del 50%. En el sistema sanitario el 18,5% de los enfermos sufrió un retraso diagnóstico mayor de 60 días, siendo los médicos responsables del 75% de la demora atribuible al sistema

Palabras clave:

Tuberculosis pulmonar

Retraso diagnóstico

Factores de riesgo

Objective

To study symptomatic pulmonary tuberculosis (PTB) diagnostic delay

Patients And Methods

Prospective study of new symptomatic PTB cases (aged = 15 years) by structured interview with the patients and their families. The main variables analyzed were patient's delay (PD), doctor's delay (DD), diagnostic process delay (DPD), health care system delay (HCSD) and total delay between the onset of symptoms and start of treatment (TD). Univariate and multivariate statistical analyses were performed for each component of delay

Results

Two hundred eighty-seven patients were studied. The mean delays in days ± standard deviations were TD 81.8 ± 77.3; PD 43.3 ± 55.7; DD 28.4 ± 59.6; DPD 10.0 ± 17.7, and HCSD 38.5 ± 62.5

Conclusions

Patients are responsible for 50% of excess delay in diagnosing symptomatic PTB. Patients in the health care system experienced diagnostic delays over 60 days in 18.5% of cases, doctors being responsible for 75% of the diagnostic delay attributable to the system

Keywords:

Pulmonary tuberculosis

Diagnostic delay

Risk fac-tors

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