[Impact of the change in criteria for hospital discharge of patients with tuberculosis based on the duration of hospitalization].
OBJECTIVE
The criteria for discharge from TB ward was changed from sputum culture negative to smear negative since January 2003 and the duration of hospitalization and the applicability of each criteria were analyzed.


METHODS
Cases hospitalized from Jan. to Dec. 2003 (Group I) were compared with those hospitalized from Jan. 2000 to Dec. 2002 (Group II). In group I, we investigated which criteria was applied for each case.


RESULTS
Shifting criteria from culture negative to smear negative, the median duration of hospitalization was shortened from 83 to 70 days, in particular in 20s, 30s and 70s. No effect however were found in patients with initially high grade excreter of AFB or extensive cavitary lesions. Although 44% of patients were discharged according to smear conversion to negative, this criteria could not be applied in 17% due to some reasons.


CONCLUSIONS
Conversion to culture negative has been conventionally used for discharge criteria in Japan considering not only contagiousness of the disease but to maintain patients adherence to treatment. After the introduction of new criteria to shorten the hospitalization periods, Japanese style DOTS after discharge would be more important to maintain patients adherence to treatment. We will continue to evaluate the treatment completion rate.
Mikami
Ayako
A
Respiratory Department, International Medical Center of Japan, Tokyo.
Toyota
Emiko
E
Ishizuka
Naoki
N
Morino
Eriko
E
Naka
Go
G
Yoshizawa
Atsuto
A
Houjo
Masayuki
M
Kawana
Akihiko
A
Kobayashi
Nobuyuki
N
Keicho
Naoto
N
Kudo
Koichiro
K
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D023801:Directly Observed Therapy; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010351:Patient Discharge / Q000592:standards*; D012720:Severity of Illness Index; D014376:Tuberculosis / Q000188:drug therapy / Q000382:microbiology*