[Shortening of hospitalization period for patients with pulmonary tuberculosis]

The development of specific chemotherapeutic agents revolutionally improved the prognosis of tuberculosis and markedly shortened the duration of the treatment. Evidence of successful treatment with short-course regimens for pulmonary tuberculosis has been accumulated. But, the duration of hospitalization tends to be determined empirically and varys among hospitals and clinicians. Generally speaking, the duration of hospitalization is longer in Japan than in the United States and Europian countries. We investigated retrospectively the duration of hospitalization, treatment period, and recurrence rate of the disease for patients with pulmonary tuberculosis who admitted to the Tokyo Metropolitan Fuchu Hospital in the years 1984, 1988, and 1991. Patients who had been previously treated for more than 2 weeks and/or, had severe complications, such as malignancy and miliary tuberculosis were excluded from the study. Cases who died during the hospitalization and discharged without permission were also excluded. Numbers of subjects in each year were 114, 114, and 115 in 1984, 1988, and 1991, respectively. A total of 343 patients (M: 254, F: 89) were enrolled to the study and their average age was 49.4 yr old. A number of patients with both smear and culture positive in sputum bacteriology was 210 (61.2%), and 42 cases (12.2%) were smear negative and culture positive. The results are as follows: (1) Mean duration of hospitalization in the years 1984, 1988, and 1991 were 141, 102, and 72 days, respectively. That is, a mean hospitalization period was shortened to about half during these seven years. (2) According to the chest x-ray classification (Group A: I, II3, B: II1, II2, III3, C: III1, III2), mean durations of hospitalization were 186 days for group A, 143 days for group B, and 108 days for group C in 1984, and 96 days, 76 days, and 59 days in 1991, respectively. (3) According to sputum bacteriology, mean durations of hospitalization were 169 days for (S+/C+) cases, 105 days for (S-/C+) cases, and 90 days for (S-/C-) cases in 1984, and 83 days, 67 days, and 41 days in 1991, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)