Differences in clinical, radiological and laboratory parameters between elderly and young patients with newly diagnosed smear‐positive pulmonary tuberculosis in Vietnam

Objectives To investigate the differences in clinical, radiological and laboratory parameters between elderly and young patients with newly diagnosed smear‐positive pulmonary tuberculosis in Vietnam. Methods This retrospective analysis included all patients hospitalised with newly diagnosed pulmonary tuberculosis with acid‐fast bacilli‐positive smear. Clinical symptoms, laboratory results and chest X‐ray findings were collected using a standardised questionnaire. Elderly was defined as those patients aged 65 years and older. Results A total of 183 patients diagnosed with new acid‐fast bacilli‐positive pulmonary tuberculosis were included in this study, with a mean age of 56.2 ± 16.3 years (minimum = 18 and maximum = 87 years). Seventy‐seven participants were aged ≥65 years, accounting for 42.1% of participants. A total of 147 (80.3%) patients were male, and the sex ratio of male/female was 4.1. Night sweats were statistically more frequent among younger patients (34.9% vs. 20.8%, p = 0.04), whereas muscle and joint pain were more predominant among the elderly (7.6% vs. 22.1%, p = 0.01). A proportion of 67.0% of younger patients and 63.6% of the elderly group were bilaterally affected. Cavitation lesions were significantly more frequent in the younger group (55.7% vs. 39.0%, p = 0.03), whereas pulmonary fibrosis occurred more frequently in elderly patients (29.3% vs. 45.4%, p = 0.02). No other significant differences in clinical symptoms, laboratory results and chest X‐ray findings were observed. Conclusion These findings underscore the importance of considering age‐related variations in the clinical and radiological presentation of tuberculosis, which can guide tailored approaches in diagnosis, management and treatment strategies for different age groups.