Sedat ALTIN, Pınar ÖZKAN, Sinem Nedime SÖKÜCÜ, Ahmet Levent KARASULU, Levent DALAR

Can hospitalization provide better compliance in smear positive tuberculosis patients?

Çalışmanın amacı; akciğer tüberkülozunda hastaneye yatış ile tedavi başarısının ilişkisini araştırmaktır. Hastanede yatmış insan immünyetmezlik virüsü (HIV) negatif, yayma pozitif 351 pulmoner tüberküloz olgusu çalışıldı. Tüm hastalar Dünya Sağlık Örgütü (DSÖ) kategori 1’e dahildi. Kronik ek hastalığı olan ve tedavide komplikasyon geliştiren hastalar çalışmadan çıkarıldı. Bölge dispanserinden takipli olan 306 hasta kontrol grubu olarak çalışmaya alındı. Gruplar tedavinin altıncı ayında tedaviye uyumları açısından değerlendirildi. Ortalama yaş 37.48 ± 13.87 idi; 204 (%31.1) hasta kadındı. Yatan hastalarda ortalama yatış süresi 25.4 ± 14.2 gündü. Toplamda 304 (%86.6) hastaneye yatan hasta tedavisini tamamlarken, geriye kalan 47 (%13.4) olgu takipten çıktı. Hastanede yatış süresi ile tedavinin tamamlanması arasında ilişki gözlenmedi (p> 0.05); 295 (%96.4) ayaktan hasta tedavisini başarıyla tamamladı. Tedaviyi tamamlamama olasılığı yatan hastalarda anlamlı olarak yüksekti (RR: 3.72 %95 GA: 1.96-7.05 p< 0.05). Sonuçlar göstermiştir ki; ek hastalığı olmayan kategori 1 hastalarına tedavinin hastanede yatarak başlanmasının tedavi sonucunu olumsuz olarak etkilediği tedaviyi tamamlayanların yüzdelerine bakılarak söylenebilir.

Hastane yatışı yayma pozitif akciğer tüberkülozlu hastalarda kompliyansı artırır mı?

The aim of the study was to explore the relation between hospitalization and the success of therapy in lung tuberculosis. Three hundred and fifty one hospitalized human immunodeficiency virus (HIV) negative, smear positive cases of pulmonary tuberculosis were studied. All cases were World Health Organization (WHO) category 1 patients. The patients with chronic additional disease and those who developed complication during therapy were excluded. Three hundred and six outpatients attending to local dispensaries were also included as control group. The groups were compared with respect to completion rates at 6 months of therapy. The average age was 37.48 ± 13.87 years; 204 patients were women (31.1%). For inpatients, mean hospital stay was 25.4 ± 14.2 days. A total of 304 (86.6%) hospitalized patients completed their treatment; the remaining 47 (13.4%) cases were not followed-up. No significant relation was observed between the length of hospital stay and completion of therapy (p> 0.05); 295 (96.4%) outpatients successfully completed their treatment. The probability of not completing the therapy was significantly higher for hospitalized patients (RR: 3.72 95% CI: 1.96-7.05 p< 0.05). Our results show that in category 1 patients without concomitant disorders, initiation of treatment at hospital has an adverse influence on the outcome of treatment, as reflected by the percentage of completers.

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