Factors Associated With Increased Length of TB Patients Hospitalization

SESSION TITLE: Tuberculosis SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: In Romania, diagnosis and treatment of TB is free to the population regardless of insurance status. TB treatment is usually initiated under hospital conditions, to ensure not only the isolation of the patient, but also to capture and resolve potential adverse effects and it is continued ambulatory. But the costs of treatment of comorbidities and of the patient transport to the medical unit which ensures DOT are not reimbursed by health insurance system. In these conditions, we wanted to analyze the average length of stay of patients with tuberculosis and the factors that influence this time. METHODS: We conducted a retrospective study of 90 cases of TB hospitalized between august 2016 and february 2017 in one of the departments of the Pneumology Institute ”Marius Nasta“ Bucharest; 62% of cases were men, 27% unemployed, 87.7% - new cases, 84.4% with pulmonary localisation, 45.55% smear positive at diagnostic time, 57.7% with comorbidities. We analyzed the correlation between socioeconomic factors (medical insurance), clinical factors (localisation, comorbidities), radiological (lesion type and extension) and bacteriological (sputum smear positively, MDR cases) and increased length of hospitalization than the average. RESULTS: Average length of stay was 37.26 days (±26.30). We established significant correlation (Pearson coefficient p=0.01) between advanced pulmonary localization, sputum smear positive, MDR cases and uninsured status, extent of lesion, cavitary lesions and increased length of hospital cases over the average. Increased length of stay was not correlated with patients age, HIV positive status or case type (new case, retreatment). CONCLUSIONS: Increased duration of hospitalization of TB cases depends on the insurance status of the patient and time till conversion of bacteriological exam of sputum. CLINICAL IMPLICATIONS: Availability of social support means to low-income and uninsured patients and screening programs for early detection in the TB risk population can reduce the length of hospitalisation. It requires further studies on the consequences of initiating DOTS ambulatory and of the early discharge of patients, DISCLOSURE: The following authors have nothing to disclose: Mara Popescu-Hagen, Rodica Traistaru, Mihaela Tanasescu, Constantin Marica, Paraschiva Postolache No Product/Research Disclosure Information