Causes and Predictive Factors of Misdiagnosis of Tuberculosis in One Private University Hospital in Korea
의약학 > 내과학
강병주 , 조경욱 , 이세원 , 최창민 , 오연목 , 이상도 , 김우성 , 김동순 , 심태선
대한결핵 및 호흡기학회
대한결핵및호흡기학회 추계학술발표초록집 2012년, 제114권 280(총1페이지)
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    Background: The aim of our study was to evaluate the "diagnosis change" rate among patients notified as tuberculosis (TB) to Korean TB surveillance system (KTBS). Methods: 1,273 patients notified to KTBS in one private university hospital in 2011 were enrolled. Patients were classified into three groups, "Active TB" (bacteriologically-confirmed or clinically diagnosed), "Diagnosis change" (initially notified as TB, but finally diagnosed as non-TB) and "Administrative error" (notified as TB due to administrative errors). Results: Except 17 patients (0.13%) in "Administrative error", "Active TB" and "Diagnosis change" included 1,097 (86.2%) and 159 patients (12.5%), respectively. There was no significant difference in the clinical characteristics between two groups. Common causes of "diagnosis change" were nontuberculous mycobacterial (NTM) disease (38.4%, 61/159), pneumonia (13.2%) and lung cancer (10.1%) in cases notified as pulmonary TB, and meningitis (5.0%) and Crohn`s disease (3.1%) in cases notified as extrapulmonary TB. Old age (≥55 years, OR=2.75), high body mass index (≥30 kg/m2, OR=3.46), and absence of TB-sugges-tive radiologic findings (OR=2.22) were predictors for "diagnosis change" in a multivariate analysis. Conclusions: Because of high rate of "Diagnosis change" in a TB notification to KTBS, TB incidence rate by KTBS maybe overestimated. Thus, when reporting annual TB notification rate in Korea, the number of patients with "Diagnosis change" should be excluded. The most common cause of "Diagnosis change" was due to NTM disease.
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