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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Key determinants of misdiagnosis of tracheobronchial tuberculosis among senile patients in contemporary clinical practice: A retrospective analysis
Fei Tang, Lian-Jun Lin, Shu-Liang Guo, Wei Ye, Xian-Kui Zha, Yu Cheng, Ying-Feng Wu, Yue-Ming Wang, Xiao-Mei Lyu, Xiao-Yun Fan, Li-Ping Lyu
Fei Tang, Xiao-Yun Fan, Department of Geriatric Respiratory and Critical Care, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Fei Tang, Wei Ye, Xian-Kui Zha, Yu Cheng, Ying-Feng Wu, Yue-Ming Wang, Xiao-Mei Lyu, Li-Ping Lyu, Department of Interventional Pulmonology and Endoscopic Diagnosis and Treatment Center, Anhui Chest Hospital, Hefei 230022, Anhui Province, China
Lian-Jun Lin, Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China
Shu-Liang Guo, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Author contributions: Fan XY, Lyu LP and Tang F contributed study concept and design; Tang F, Ye W, Zha XK, Cheng Y, Wu YF and Wang YM contributed acquisition of subjects and/or data; Lin LJ and Tang F contributed analysis and interpretation of data; Tang F contributed preparation of manuscript; All authors read and approved the final manuscript.
Supported by China's 13th Five-Year Major Science and Technology Project, No. 2018ZX10302-302.
Institutional review board statement: The study was approved by the ethics committee of the Anhui Chest Hospital. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent statement: Due to the retrospective nature of this study, informed consent was waived.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xiao-Yun Fan, MD, Chief Doctor, Department of Geriatric Respiratory and Critical Care, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui Province, China. 115367686@qq.com
Received: January 23, 2021
Peer-review started: January 23, 2021
First decision: April 29, 2021
Revised: May 11, 2021
Accepted: July 12, 2021
Article in press: July 12, 2021
Published online: September 6, 2021
ARTICLE HIGHLIGHTS
Research background
Tracheobronchial tuberculosis (TBTB) is commonly misdiagnosed in clinical practice, especially among senile patients.
Research motivation
To characterize senile patients with TBTB and to identify the potential causes of misdiagnosis.
Research objectives
One hundred twenty patients with senile TBTB who were admitted to the Anhui Chest hospital between May 2017 and May 2019 were retrospectively analyzed.
Research methods
Patients were classified as diagnosed group (n = 58) and misdiagnosed group (n = 62). Clinical manifestations, laboratory results, radiographic data, and endoscopic findings were compared between the two groups to identify the major factors that contribute to the misdiagnosis or delayed diagnosis of the disease.
Research results
Patients in the misdiagnosed group were most commonly diagnosed as pulmonary tuberculosis (non-TBTB, 29/62, 46.8%), general pneumonia (9/62, 14.5%), chronic obstructive pulmonary disease (8/62, 12.9%), and tracheobronchial carcinoma (7/62, 11.3%). The misdiagnosed group had lower proportion of patients who underwent bronchoscopy [33.87% (21/62) vs 87.93% (51/58)], chest CT scan [69.35% (43/62) vs 98.28% (57/58)], and those who showed CT signs of tuberculosis [27.91% (12/62) vs 50% (29/58)] as compared to that in the diagnosed group (P < 0.05).
Research conclusions
Insufficient or inaccurate radiographic or bronchoscopic assessment was the major cause of delayed diagnosis of TBTB.
Research perspectives
Increased implementation and better interpretation of CT scan and early implementation of bronchoscopy can help reduce misdiagnosis of senile TBTB.
