A high-resolution computed tomography-based scoring system to differentiate the most infectious active pulmonary tuberculosis from community-acquired pneumonia in elderly and non-elderly patients

doi:10.1007/s00330-014-3279-6

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Please use this identifier to cite or link to this item: https://ir.cnu.edu.tw/handle/310902800/28485

Title:	A high-resolution computed tomography-based scoring system to differentiate the most infectious active pulmonary tuberculosis from community-acquired pneumonia in elderly and non-elderly patients
Authors:	Yeh, Jun-Jun Chen, Solomon Chih-Cheng Chen, Cheng-Ren Yeh, Ting-Chun Lin, Hsin-Kai Hong, Jia-Bin Wu, Bing-Tsang Wu, Ming-Ting
Contributors:	嬰幼兒保育系
Keywords:	High-resolution CT Patient isolation Sputum smear Tuberculosis
Date:	2014-10
Issue Date:	2015-05-06 21:18:00 (UTC+8)
Publisher:	Springer
Abstract:	The objective of this study was to use high-resolution computed tomography (HRCT) imaging to predict the presence of smear-positive active pulmonary tuberculosis (PTB) in elderly (at least 65 years of age) and non-elderly patients (18-65 years of age). Patients with active pulmonary infections seen from November 2010 through December 2011 received HRCT chest imaging, sputum smears for acid-fast bacilli and sputum cultures for Mycobacterium tuberculosis. Smear-positive PTB was defined as at least one positive sputum smear and a positive culture for M. tuberculosis. Multivariate logistic regression analyses were performed to determine the HRCT predictors of smear-positive active PTB, and a prediction score was developed on the basis of receiver operating characteristic curve analysis. Of 1,255 patients included, 139 were diagnosed with smear-positive active PTB. According to ROC curve analysis, the sensitivity, specificity, positive predictive value, negative predictive value, false positive rates and false negative rates were 98.6 %, 95.8 %, 78.5 %, 99.8 %, 4.2 % and 1.4 %, respectively, for diagnosing smear-positive active PTB in elderly patients, and 100.0 %, 96.9 %, 76.5 %, 100.0 %, 3.1 % and 0.0 %, respectively, for non-elderly patients. HRCT can assist in the early diagnosis of the most infectious active PTB, thereby preventing transmission and minimizing unnecessary immediate respiratory isolation. aEuro cent HRCT can assist in the early diagnosis of the infectious active PTB aEuro cent HRCT imaging is useful to predict the presence of smear-positive active PTB aEuro cent Predictions from the HRCT imaging are valid even before sputum smear or culture results.
Relation:	European Radiology, v.24 n.10, pp.2372-2384
Appears in Collections:	[Dept. of Childhood Education and Nursery] Periodical Articles

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