Clinical, Radiological Features and Treatment Outcomes of Tuberculosis in Patients Aged 75 years and Older

Abstract

Abstract Introduction Tuberculosis is a significant contributor of morbidity and mortality. With a progressively aging population, TB is increasingly encountered in older adults. Understanding the clinical presentation and optimal treatment strategies for TB in this population is essential. Method Clinical, radiological features, treatment and outcome of TB in patients aged 75 years or older was evaluated retrospectively. Results Among 92 elderly tuberculosis patients, most were male (76.1%) with a mean age of 82.5 years. Pulmonary TB was diagnosed in 52.2% of patients, Extra Pulmonary TB in 32.6%, and Disseminated TB in 15.2%. Comorbidities included Diabetes Mellitus (59.8%) and Congestive Heart Failure (41.3%). The most common presentation symptoms included cough (51.1%), fever (43.5%), dyspnea (39.1%), and weight loss (31.5%). Delay of TB diagnosis for up to 3 months was observed in 31.5% of patients. Weight loss and male gender were significant predictors of delayed diagnosis. Laboratory findings varied among TB types, with disseminated TB showing higher eosinophilia and thrombocytopenia. Completion of an initial RIPE treatment protocol achieved in 67.6% of patients. Mortality during treatment occurred in 23.9% of patients. Pulmonary TB was associated with higher mortality compared to extrapulmonary TB (p=0.007). Conclusion Tuberculosis is associated with high mortality in patients above age of 75. There is still a substantial delay in TB diagnosis in elderly. RIPE regimen is frequently changed due to side effect. Alternative regimen choices were quite variable. More studies on tuberculosis in this patient’s population is needed to define the best effective therapeutic approach.