title: Pulmonary tuberculosis among patients hospitalised with community-acquired pneumonia in a tuberculosis-prevalent area.
abstract: METHODS
  A suburban teaching hospital in a tuberculosis (TB) prevalent area.
  
  
  OBJECTIVE
  To evaluate the proportion of pulmonary TB among patients hospitalised with suspected community-acquired pneumonia (CAP), and to develop a diagnostic index for identifying TB among these patients.
  
  
  METHODS
  TB cases confirmed using 1) sputum culture, or 2) both sputum acid-fast bacilli smear and polymerase chain reaction for Mycobacterium tuberculosis, were compared with non-tuberculous CAP by demographic, clinical, laboratory and radiographic information. Using multiple logistic regression analysis, risk factors for TB were identified. A diagnostic index was developed by summing up their simplified regression coefficients. Its performance was checked using c-statistic.
  
  
  RESULTS
  TB was the second leading cause of CAP (37/528, 7.0%). Risk factors were initial symptoms >7 days, serum albumin <3.5 g/dl, cavitary/nodular infiltrates and upper lobe involvement (1 point for each). The c-statistic of the index was 0.856 (95%CI 0.789-0.923), and for bootstrapping samples of 1000 repetitions it was 0.856 (95%CI 0.791-0.921). For scores ≥2, sensitivity and specificity were respectively 81.1% and 75.8%.
  
  
  CONCLUSIONS
  TB is one of the leading causes of CAP in TB-prevalent areas. Our diagnostic index may help clinicians identify TB immediately from CAP and initiate appropriate isolation and optimal treatment.
authors.affiliation: Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: S-B
authors.initials: SB
authors.lastname: Chon
authors.forename: T S
authors.initials: TS
authors.lastname: Kim
authors.forename: W S
authors.initials: WS
authors.lastname: Oh
authors.forename: S-J
authors.initials: SJ
authors.lastname: Lee
authors.forename: S S
authors.initials: SS
authors.lastname: Han
authors.forename: W J
authors.initials: WJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060085:Coinfection; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D011237:Predictive Value of Tests; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology