当院〔国立療養所広島病院〕における肺結核患者の死因の変遷

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A retrospective study, as to the causes of death, on 298 patients dismissed by death among 4, 194 patients discharged from the National Hiroshima Sanatorium during the last ten-years period (Group A), comparing with 260 cases among the 5, 420 discharged_ during the preceding ten-years period (Group B), has been performed. The results are as follows. 1) The overall mortality rate to the total number of patients dismissed has increased during the last ten years (7.1%) as compared wtih that of the preceding decade (4.8%), and the mor tality from tuberculosis has failed to decrease. 2) The average age of death in Group A (54.5) was higher than that in Group B (38.8). This does not totally imply the prolonged duration of illness but advanced ages at the onset of pulmonary tuberculosis with the patients in Group A seem to account in greater part for the hightened average age of death. 3) Cardiopulmonary failure accounts, among other immediate causes of death, for 23.8% of all deaths in Group A in contrast to 7.7% of all the deaths in Group B, whereas deaths due to tuberculosis, conversely, declined to 35.2% for Group A as compared with 51.5% for Group B. The combined mortalities (cardiopulmonary failure and tuberculosis) being virtually comparable for both groups, i. e. 59.0% and 59.2%, respectively. The finding indicates that, in Group A, those who would have otherwise succumbed to tuberculosis became improved to attain an “inactivec” state by the advanced chemotherapy without significant amelioration in pulmonary function. 4) In both Groups A and B, deaths from hemoptysis were more frequent in patients under 60 years of age, patients with enlarged cavitations of over 7.0 cm diameter and with for ad vanced cavitary type 5) Complication of pulmonary carcinoma was encountered in 2.3% of those who died in Group A, five males and two females. Of these seven cases, four showed sputa positive for tuber cle bacilli by culture at the time of death. 6) Sixteen (20.3%) who died from tuberculosis out of 79 patients who were discovered their disease during the period since 1966 in Group A were assessed individually as to factors concerned with the death from tuberculosis to determine whether there might be any scope for possible future reduction of such cases. The results indicated the importance of making further thorough health examinations. 7) The rate of mortality from tuberculosis (20.3%) among those who were discovered their disease during the decade since 1966 in Group A is remarkably lower than the corresponding rate of 51.5% for Group B.
一般社団法人日本結核病学会の論文

当院〔国立療養所広島病院〕における肺結核患者の死因の変遷

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