RT Journal Article
SR Electronic
T1 Baseline and treatment completion chest radiographs in pulmonary and extra-pulmonary tuberculosis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2606
VO 38
IS Suppl 55
A1 Bartington, Suzanne
A1 Hopkins, Susan
A1 Cash, Charlotte
A1 Cleverley, Joanne
A1 Cropley, Ian
A1 Lipman, Marc
YR 2011
UL https://publications.ersnet.org//content/38/Suppl_55/p2606.abstract
AB Background: Chest radiographs (CXR) are key to the diagnosis & management of tuberculosis (TB). End-treatment CXR (E-CXR) provide information on therapy response & risk of post-treatment pulmonary sequelae.Objectives: 1.To report factors associated with baseline CXR (B-CXR) in pulmonary TB (PTB) & extra-pulmonary TB (EPTB).2.To document the use of E-CXR in subjects with abnormal (abN) baseline CXR (B-CXR).Study design: Retrospective data for TB patients at our hospital (1.1.06 - 31.12.08) were obtained from the London TB Register. Patients were classified by TB notification as PTB, EPTB or EPTB with pulmonary involvement (EPTB+PTB). B-CXR (2mths pre- to 1mth post- start TB treatment) & E-CXR (2mths peri-end TB treatment) were reviewed blind by 2 respiratory radiologists.Results: Of 305 patients, 113 (37.0%) were diagnosed with PTB, 155 (50.8%) EPTB & 37 (12.1%) EPTB+PTB. 285 (93.4%) had B-CXR performed in the correct time period (early/late 5.6%, not performed 1.0%) with no significant difference by TB clinical status. Female patients were less likely to have a B-CXR (F: 89.6%, M: 97.4%, p<0.001) which remained significant in multivariable analysis. 149 (52.3%) had E-CXR: more likely in those with abN B-CXR (63.1% abN, 23.8% normal, p<0.001). 116 of 198 (58.6%) with abN B-CXR had an E-CXR with radiology review available. Of these 24 (20.7%) had abN E-CXR including radiological evidence of active TB (n=14, 12.1%).Conclusion: B-CXR was performed in 99% cases. E-CXR use was sub-optimal in those with baseline abnormalities, especially as one-fifth of those performed remained abnormal and often suggestive of active disease.