Scientific Letter
Factors Associated With a Long Mean Hospital Stay in Patients Hospitalized With Tuberculosis
Factores asociados con estancia media prolongada en pacientes ingresados por tuberculosis
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"Factors Associated With a Long Mean Hospital Stay in Patients Hospitalized With Tuberculosis" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "409" "paginaFinal" => "410" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "María del Carmen Vera Sánchez-Rojas, Emma Muñoz Pérez, Ángeles Muñoz Pérez, Salvador Valero Cifuentes, Eva García Villalba, María de la Paz Egea Campoy, Alfredo Cano Sánchez, Enrique Bernal Morell" "autores" => array:8 [ 0 => array:4 [ "nombre" => "María del Carmen Vera" "apellidos" => "Sánchez-Rojas" "email" => array:1 [ 0 => "mcvsr75@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Emma Muñoz" "apellidos" => "Pérez" "referencia" => array:1 [ 0 => array:2 [ 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tuberculosis" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Tuberculosis (TB) is still a public health issue that affects a large number of individuals and generates high healthcare costs.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">1–3</span></a> Moreover, hospital stays in patients with TB tend to be prolonged; over 15 days in most cases.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">2,3</span></a> In Spain, between 1999 and 2009, mean hospital stay was 14 days with a standard deviation of 12 days.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Very few studies have been conducted in Spain to explain the reasons for these prolonged mean stays. The aim of this study was to analyze TB patients who were admitted to hospital for mean stays of longer than 15 days, and to evaluate the associated factors.</p><p id="par0015" class="elsevierStylePara elsevierViewall">This was a retrospective observational study analyzing all patients admitted for TB between January 2005 and August 2012 in the Hospital General Universitario Reina Sofía, Murcia.</p><p id="par0020" class="elsevierStylePara elsevierViewall">On the basis of data published by Thomas et al., <a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a> mean stay was considered prolonged if it was longer than 15 days.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The analysis included 165 patients. Mean patient age was 37.69 (14.42) years, 66% were men, 66% immigrants, 78.2% had pulmonary TB, 21.8% had extrapulmonary TB, and 22.4% presented complications during admission.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Mean stay of all TB patients was 21.94 (29.7) days, median 15 (IQR, 11–24) days, and longer than 15 days in 54.5% of patients. Mean stay of patients with pulmonary tuberculosis was 18 (12.21) days, median 14 days (IQR, 11–22).</p><p id="par0035" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the univariate analysis of factors associated with prolonged mean stay (≥15 days).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Variables associated independently with prolonged mean stay in the logistic regression analysis were delayed diagnosis (health system delay) beyond the fourth day (OR 17.94; 95% CI 3.47–92.79; P=.001), complications during admission (OR 7.87; 95% CI 2.63–23.8; P<.005), history of bronchial disease (OR 6.21; 95% CI 1.17–33.3; P=.031) and weight loss, weakness/asthenia and anorexia at time of presentation (OR 3.89; 95% CI 1.83–8.26; P<.005) or bilateral involvement (OR 2.64; 95% CI 1.25–5.58; P=.011).</p><p id="par0045" class="elsevierStylePara elsevierViewall">The most important factor associated with prolonged stay was delayed diagnosis, to the extent that a delay beyond the fourth day increased by 18-fold the probability of stays longer than 15 days.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Delayed diagnosis, moreover, helps keep tuberculosis endemic,<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">5–7</span></a> and it can also increase morbidity and mortality,<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a> and extend hospital stay,<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">5–9</span></a> underlining the importance of early diagnosis and the implementation of preventive measures.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Factors that influence this delay are wide-ranging, but, as we found in our study, advanced age, extrapulmonary involvement, disease site other than the upper lobes, and a negative Ziehl sputum test are determinant factors.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">6–8</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Complications during hospitalization have also been described as a key factor in prolonging mean hospital stay.<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">8,10,11</span></a> Complications most commonly observed were toxicities associated with anti-tuberculous drugs (mainly liver involvement), and the need for major surgery in patients with extrapulmonary TB.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Other factors associated with prolonged stay were a history of bronchial disease (risk factor for developing TB and complications<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">1,8,10</span></a>), while bilateral involvement with asthenia, anorexia, and weight loss are associated with more severe disease,<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">1</span></a> leading to a longer mean stay.</p><p id="par0070" class="elsevierStylePara elsevierViewall">It is interesting to point out that a hospital stay of longer than 15 days is not an isolated problem in our center; it also occurs in other Spanish hospitals. Indeed, the analysis of the minimum basic data set of discharges from Internal Medicine departments of the Spanish National Health System in 2005–2010 showed that the mean stay was 18.7 days (range 19–44), with 17.8 (SD 19.3) days for patients with extrapulmonary tuberculosis, 18 (SD 22.25) days for patients with pulmonary tuberculosis, and 24.7 (SD 22) days for patients with disseminated disease.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">3</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">One of the main reasons for keeping patients hospitalized for such long periods is to avoid propagation of the TB. However, the risk of propagation is not reduced by hospitalization, since exposure occurs before diagnosis, and the risk of contagion falls dramatically after treatment is started.<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">12–14</span></a> In a study performed in New York, up to 40% of hospitalizations were found to be inappropriate on this basis.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Hospitalization, and particularly long hospitalization, is not always necessary.<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">4,14</span></a> It is generally an inefficient use of resources and probably up to 20%–40% of admissions among TB patients could be avoided.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">In conclusion, most patients admitted with TB have a prolonged mean stay (≥15 days) associated with delayed diagnosis, asthenia, anorexia, and weight loss, previous bronchial disease, bilateral involvement, and complications during admission.</p><p id="par0090" class="elsevierStylePara elsevierViewall">The most important factor for prolonging mean hospital stay in these patients was delayed diagnosis, so it is essential that the optimal measures for avoiding this delay are implemented, including improved TB education for physicians and the general public (in order to increase the diagnostic suspicion), and better access to the health system. We also believe that a large number of TB patients could benefit from outpatient treatment, reducing the length of hospital stay, or even avoiding hospitalization altogether. This would require, most importantly, the use of standardized protocols, improved health education among patients and family members about isolation measures in the home and treatment compliance, and multidisciplinary teams for supervised outpatient treatment or directly observed therapy.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">15</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sánchez-Rojas MC, Pérez EM, Pérez ÁM, Cifuentes SV, Villalba EG, Campoy MP, et al. Factores asociados con estancia media prolongada en pacientes ingresados por tuberculosis. Arch Bronconeumol. 2017;53:409–410.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">CCI: Charlson comorbidity index; ICU: intensive care unit.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col"><15 days \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">≥15 days \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Significance \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span>=75 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span>=90 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.25 (11.82) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.56 (17.43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.007 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male sex (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53 (70.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59 (65.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.484 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Immigration (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53 (70.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56 (62.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.254 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Predisposing factors (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58 (64.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.062 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HIV infection (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (7.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.784 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Homeless (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (8.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (14.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.207 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alcoholism (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (16.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 (25.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.146 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">History of bronchial disease (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (13.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.015 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoptysis (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 (37.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (17.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Asthenia, anorexia, and weight loss (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 (34.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 (60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sepsis (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (16.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.096 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">APACHE <span class="elsevierStyleSmallCaps">II</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.6 (3.09) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.05 (3.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.012 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bilateral involvement (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 (32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46 (51.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.013 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Extrapulmonary involvement (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (13.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 (28.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.016 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pleural effusion (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (10.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19 (21.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.071 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bacilliferous on admission (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 (52) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51 (58.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.754 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Drug resistance (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (19.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (27.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.308 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Complications (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32 (35.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CCI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.77 (0.95) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.96 (3.44) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.058 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">UCI admission (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.853 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lost-to-follow-up (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (24.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 (38.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.047 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cure (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 (91.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49 (74.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.011 (of <span class="elsevierStyleItalic">n</span>=125) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Relapse (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (9.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (19.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.069 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Death (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (9.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.373 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Delayed diagnosis, days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (3.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.6 (7.27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1449484.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Univariate Analysis of Factors Associated With Mean Hospital Stay ≥15 Days.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib0080" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Current concepts tuberculosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Zumla" 1 => "M. Raviglione" 2 => "R. Hafner" 3 => "C.F. von Reyn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMra1200894" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2013" "volumen" => "368" "paginaInicial" => "745" "paginaFinal" => "755" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23425167" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0085" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiología de las hospitalizaciones por tuberculosis en España: análisis del conjunto mínimo básico de datos 1999–2009" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.R. Culqui" 1 => "E. Rodríguez-Valíny" 2 => "M.V. Martínez de Aragón" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0213-005X(15)30009-4" "Revista" => array:6 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2015" "volumen" => "33" "paginaInicial" => "9" "paginaFinal" => "15" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26320990" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0090" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[Espec Congr]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Análisis de la Infección tuberculosa en los servicios de Medicina Interna españoles. Periodo 2005–2010" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Zapatero" 1 => "J. Vergas" 2 => "G. Ropero" 3 => "M. Méndez" 4 => "S. Plaza" 5 => "C. Cuervo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2013" "volumen" => "213" "paginaInicial" => "102" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0095" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hospitalizations for tuberculosis in New York City: how many could be avoided?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.A. Thomas" 1 => "F. Laraque" 2 => "S. Munsiff" 3 => "A. Piatek" 4 => "T.G. Harris" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Tuberc Lung Dis" "fecha" => "2010" "volumen" => "14" "paginaInicial" => "1603" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21144247" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0100" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trends in duration of hospitalization for patients with tuberculosis in Montreal, Canada from 1993 to 2007" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Dehghani" 1 => "R. Allard" 2 => "J. Gratton" 3 => "L. Marcotte" 4 => "P. Rivest" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Can J Public Health" "fecha" => "2011" "volumen" => "102" "paginaInicial" => "108" "paginaFinal" => "111" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21608381" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0105" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Time delays in diagnosis of pulmonary tuberculosis: a systematic review of literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.T. Sreeramareddy" 1 => "K.V. Panduru" 2 => "J. Menten" 3 => "J. van den Ende" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2334-9-91" "Revista" => array:5 [ "tituloSerie" => "BMC Infect Dis" "fecha" => "2009" "volumen" => "9" "paginaInicial" => "91" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19519917" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0110" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Factors associated with patient, and diagnostic delays in Chinese TB patients: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Li" 1 => "J. Ehiri" 2 => "S. Tang" 3 => "D. Li" 4 => "Y. Bian" 5 => "H. Lin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1741-7015-11-156" "Revista" => array:5 [ "tituloSerie" => "BMC Med" "fecha" => "2013" "volumen" => "11" "paginaInicial" => "156" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23819847" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0115" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Longer hospital stay is associated with higher rates of tuberculosis-related morbidity and mortality within 12 months after discharge in a referral hospital in Sub-Saharan Africa" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.M. Zetola" 1 => "N. Macesic" 2 => "S.S. Shin" 3 => "A. Peloso" 4 => "R. Ncub" 5 => "J.D. Klausner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2334-14-409" "Revista" => array:5 [ "tituloSerie" => "BMC Infect Dis" "fecha" => "2014" "volumen" => "14" "paginaInicial" => "409" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25047744" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0120" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estudio del retraso diagnóstico de la tuberculosis pulmonar sintomática" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.N. Altet Gómez" 1 => "J. Alcaide Megías" 2 => "J. Canela Soler" 3 => "C. Milá Augé" 4 => "M.A. Jiménez Fuentes" 5 => "M.L. de Souza Galvao" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2003" "volumen" => "39" "paginaInicial" => "146" "paginaFinal" => "152" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12716554" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0125" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term hospitalization for tuberculosis control. Experience with a medical–psychosocial inpatient unit" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Singleton" 1 => "M. Turner" 2 => "R. Haskal" 3 => "S. Etkind" 4 => "M. Tricarico" 5 => "E. Nardell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "1997" "volumen" => "278" "paginaInicial" => "838" "paginaFinal" => "842" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9293992" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0130" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The impact of comorbidity on mortality following in-hospital diagnosis of tuberculosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V.K. Rao" 1 => "E.P. Iademarco" 2 => "V.K. Fraser" 3 => "M.H. Kollef" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1998" "volumen" => "114" "paginaInicial" => "1244" "paginaFinal" => "1252" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9823996" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0135" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How contagious is tuberculosis?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Kent A. Sepkowitz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "1996" "volumen" => "23" "paginaInicial" => "954" "paginaFinal" => "962" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8922785" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0140" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tuberculosis in immigrants: clinical and epidemiological differences as compared to the native population (1999–2002)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.M. Ramos" 1 => "M. Masiá" 2 => "J.C. Rodríguez" 3 => "I. Padilla" 4 => "M.J. Soler" 5 => "F. Gutiérrez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2004" "volumen" => "22" "paginaInicial" => "315" "paginaFinal" => "318" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15228896" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0145" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reconsideration of the admission and discharge criteria of tuberculosis patients in Japan" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Masuyama" 1 => "H. Igari" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Kekkaku" "fecha" => "2013" "volumen" => "88" "paginaInicial" => "373" "paginaFinal" => "385" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23672177" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0150" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "What is DOTS? A guide to understanding the WHO-recommended TB control strategy known as DOTS" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "World Health Organization" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1999" "editorial" => "World Health Organization" "editorialLocalizacion" => "Geneva, Switzerland" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000007/v1_201706290145/S1579212917301854/v1_201706290145/en/main.assets" "Apartado" => array:4 [ "identificador" => "49861" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000007/v1_201706290145/S1579212917301854/v1_201706290145/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917301854?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 11 | 3 | 14 |
| 2024 October | 104 | 19 | 123 |
| 2024 September | 71 | 18 | 89 |
| 2024 August | 71 | 43 | 114 |
| 2024 July | 77 | 24 | 101 |
| 2024 June | 71 | 39 | 110 |
| 2024 May | 91 | 25 | 116 |
| 2024 April | 45 | 38 | 83 |
| 2024 March | 53 | 19 | 72 |
| 2024 February | 36 | 26 | 62 |
| 2023 March | 7 | 4 | 11 |
| 2023 February | 31 | 13 | 44 |
| 2023 January | 28 | 30 | 58 |
| 2022 December | 52 | 33 | 85 |
| 2022 November | 50 | 33 | 83 |
| 2022 October | 49 | 40 | 89 |
| 2022 September | 28 | 31 | 59 |
| 2022 August | 36 | 43 | 79 |
| 2022 July | 38 | 36 | 74 |
| 2022 June | 34 | 34 | 68 |
| 2022 May | 36 | 33 | 69 |
| 2022 April | 43 | 33 | 76 |
| 2022 March | 50 | 46 | 96 |
| 2022 February | 39 | 25 | 64 |
| 2022 January | 50 | 48 | 98 |
| 2021 December | 50 | 46 | 96 |
| 2021 November | 45 | 38 | 83 |
| 2021 October | 50 | 52 | 102 |
| 2021 September | 31 | 47 | 78 |
| 2021 August | 30 | 32 | 62 |
| 2021 July | 44 | 22 | 66 |
| 2021 June | 35 | 31 | 66 |
| 2021 May | 43 | 40 | 83 |
| 2021 April | 106 | 85 | 191 |
| 2021 March | 46 | 29 | 75 |
| 2021 February | 27 | 29 | 56 |
| 2021 January | 30 | 18 | 48 |
| 2020 December | 36 | 21 | 57 |
| 2020 November | 19 | 18 | 37 |
| 2020 October | 26 | 20 | 46 |
| 2020 September | 27 | 10 | 37 |
| 2020 August | 23 | 9 | 32 |
| 2020 July | 25 | 28 | 53 |
| 2020 June | 17 | 5 | 22 |
| 2020 May | 20 | 10 | 30 |
| 2020 April | 28 | 24 | 52 |
| 2020 March | 22 | 11 | 33 |
| 2020 February | 26 | 22 | 48 |
| 2020 January | 37 | 21 | 58 |
| 2019 December | 21 | 9 | 30 |
| 2019 November | 21 | 24 | 45 |
| 2019 October | 16 | 20 | 36 |
| 2019 September | 34 | 16 | 50 |
| 2019 August | 34 | 17 | 51 |
| 2019 July | 26 | 20 | 46 |
| 2019 June | 25 | 24 | 49 |
| 2019 May | 35 | 31 | 66 |
| 2019 April | 33 | 29 | 62 |
| 2019 March | 23 | 14 | 37 |
| 2019 February | 22 | 18 | 40 |
| 2019 January | 12 | 19 | 31 |
| 2018 December | 22 | 26 | 48 |
| 2018 November | 86 | 28 | 114 |
| 2018 October | 159 | 26 | 185 |
| 2018 September | 42 | 13 | 55 |
| 2018 August | 1 | 0 | 1 |
| 2018 July | 1 | 0 | 1 |
| 2018 May | 22 | 1 | 23 |
| 2018 April | 59 | 5 | 64 |
| 2018 March | 86 | 6 | 92 |
| 2018 February | 69 | 8 | 77 |
| 2018 January | 215 | 6 | 221 |
| 2017 December | 161 | 12 | 173 |
| 2017 November | 40 | 21 | 61 |
| 2017 October | 25 | 12 | 37 |
| 2017 September | 0 | 1 | 1 |
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