The clinical findings of pulmonary tuberculosis in elderly patients aged 75 years of age or older (elderly group) were compared with the middle-ged patients aged between 45 and 54 years of age (middle-aged group) and the young patients aged 34 years of age or younger (young group). The elderly patients who died in hospital were also compared with the elderly patients who survived. Study subjects were culture-positive pulmonary tuberculosis patients who were discharged from our hospital from December 1996 to November 1998. There were 79 patients in the elderly group, 95 in the middle-aged group, and 88 in the young group. The results were as follows.
1) The male/female ratio was significantly lower in the elderly group (1.9: 1) than the middle-aged-group (6.9: 1).
2) Complication was noted more frequently in the elderly group. However, diabetes mel-litus was noted less frequently in the elderly group (12.7%) than the middle-aged group (28.4%).
3) The frequency of cavitation was lower in the elderly group (59.5%) than the middleaged group (87.4%).
4) The fever over 38°C was noted less frequently in the elderly group (17.7%) than the other groups, while the frequency of the fever over 37°C showed no significant differ ence between the elderly group and the other groups.
5) The frequencies of hypoalbuminemia and appetite loss were higher in the elderly group than the other groups.
6) The elderly group showed high mortality rate of 31.6%. The complication with cerebrovascular disease was noted significantly higher in the patients who died in hospital than those who survived. The frequency of widespread infiltrates, fever over 38°C, neutrophilia, hypoalbuminemia and appetite loss were all significantly higher in the patients who died in hospital while their sputa were still positive on culture than those who survived.
Our study clearly showed the features of elderly pulmonary tuberculosis patients in comparison with middle-aged patients and young patients. These features are very impor tant to suspect the diagnosis of pulmonary tuberculosis in elderly patients with some atypical manifestation. Our study also suggests that the delay in diagnosing tuberculosis causes more frequently the patients' deterioration and death in elderly patients than in middle-aged patients and young patients.
