Missed opportunities for detecting tuberculosis: An analysis of emergency department visits before the diagnosis

Rev Clin Esp (Barc). 2019 Oct;219(7):390-393. doi: 10.1016/j.rce.2018.11.010. Epub 2019 Mar 20.
[Article in English, Spanish]

Abstract

Objective: To assess the frequency of care in an emergency department in the 6months 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 6months 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 6months prior to the diagnosis, and this diagnostic possibility was often not suspected.

Keywords: Diagnosis; Diagnóstico; Emergency department; Pulmonary tuberculosis; Servicio de Urgencias; Tuberculosis pulmonar.