Tuberculosis infection via the emergency department among inpatients in South Korea: a propensity score matched analysis of the National Inpatient Sample.
BACKGROUND
Emergency departments (EDs) carry a high risk of infectious disease transmission and have also been implicated in tuberculosis (TB) outbreaks.


AIM
To determine if patients who visit EDs have an increased risk of TB infection. Using South Korean inpatient sample data (2012), the risk of TB occurrence during 90 days after hospitalization for patients admitted via EDs was compared with that for patients admitted via outpatient clinics.


METHODS
The data of the 2012 Health Insurance Review and Assessment Service - National Inpatient Sample were used. TB diagnosis was based on International Classification of Diseases Version 10 [all TB (A15-A19), pulmonary TB (A15-A16) and extrapulmonary TB (A17-A18)].


FINDINGS
After propensity score matching using the demographic and clinical characteristics of the patients, 191,997 patients (64,017 patients admitted via EDs and 127,908 patients admitted via outpatient clinics) were included in this study. There was no significant difference in baseline patient characteristics between the two groups. The percentage of patients with TB admitted via EDs was higher than that of patients admitted via outpatient clinics. The likelihood of active TB occurrence was 30% higher for all TB [hazard ratio (HR) 1.30; 95% confidence interval (CI) 1.12-1.52] and pulmonary TB (HR 1.30; 95% CI 1.10-1.53) in patients admitted via EDs compared with patients admitted via outpatient clinics; this difference was significant. However, no difference in the occurrence of extrapulmonary TB was observed between the two groups.


CONCLUSIONS
The likelihood of TB infection was greater in patients admitted via EDs than in patients admitted via outpatient clinics.
['Min|J-Y|JY|', 'Kim|H-J|HJ|', 'Yoon|C|C|', 'Lee|K|K|', 'Yeo|M|M|', 'Min|K-B|KB|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D018562:Disease Transmission, Infectious D004632:Emergency Medical Services D004636:Emergency Service, Hospital D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D057216:Propensity Score D056910:Republic of Korea D018570:Risk Assessment D014376:Tuberculosis D055815:Young Adult
Inpatient Propensity score matching TB Nosocomial infections