The results pointed to imminent risk of breach of patient safety, emphasizing the need for implementation of protocols and predictive scales such as the Morse scale.

Objective: To evaluate the epidemiological, clinical and evolutionary aspects of tuberculosis in elderly patients of a university hospital in Belém, Pará. Method: A cross-sectional study was conducted in a university hospital, where 82 records of cases of tuberculosis in elderly patients were analyzed. The data was analyzed by applying the G-test, assuming a level of α=0.05 (5%) and a value of p=0.05. Results: Most of the elderly patients were male (64.6%), aged 60-69 years, especially among men (64.2%). Most were new cases of tuberculosis (95.1%), with a pulmonary clinical form (75.6%), associated diseases (69.5%) and a length of stay exceeding 21 days. Fever (67.1%), dyspnea (64.6%), weight loss (61.0%), productive cough (59.8%), chest pain (51.2%) were the main signs and symptoms. Regarding treatment, there was a high percentage of adverse reactions (50%), predominantly gastrointestinal events (70.7%). Most patients were cured (59.8%), but mortality from tuberculosis was considered high (15.9%). In terms of the exposure variables and outcome, there was a statistically significant difference for the age group ( p=0.017), length of stay ( p=0.000) and adverse reactions ( p=0.018) only. Conclusion:The clinical presentation and therapeutic management of tuberculosis among the elderly has characteristics peculiar to this group, making it important to strengthen strategies that facilitate early identification of suspected cases of TB among elderly persons in the community, which should take place mainly through the primary care system.

O processo de envelhecimento torna o idoso mais susceptível ao adoecimento por tuberculose, devido à imunossenescência, além das comorbidades frequentes nesse grupo etário, que tornam mais complexos o diagnóstico e o manejo clínico nos idosos. Dessa forma, objetivou-se avaliar os elementos de diagnóstico de tuberculose pulmonar em idosos atendidos no Hospital Universitário da Universidade Federal do Pará, Pará, referência em tuberculose pelo Ministério da Saúde. Trata-se de um estudo do tipo coorte retrospectivo, cuja amostra foi de 62 casos de tuberculose pulmonar em idosos diagnosticados no período entre 2009 e 2013. Houve concentração na faixa etária de 60-69 anos (56,5%). Os principais sinais e sintomas foram febre (69,4%), tosse produtiva (67,7%), dispneia (66,1%) e emagrecimento (66,1%). Dentre os exames laboratoriais, o de baciloscopia do escarro predominou (90,3%), sendo positivo na maior parte dos casos. Os exames de imagem foram realizados na maioria dos idosos (93,5%), sendo suspeito em grande parcela desses (98,3%). Na relação da faixa de idade com a prova terapêutica, não se verificou significância estatística (p=0,4318). O diagnóstico da tuberculose no idoso apresenta especificidades, fazendo-se necessário o fortalecimento de estratégias de cuidado na Atenção Primária à Saúde.

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