EPIDEMIOLOGICAL PROFILE OF EXTRAPULMONARY TUBERCULOSIS IN RIO GRANDE DO SUL: ANALYSIS OF HOSPITALIZATIONS, LENGTH OF STAY, AND LETHALITY (2013–2024)

Extrapulmonary tuberculosis (EP-TB) presents significant diagnostic and therapeutic challenges, with a scarcity of detailed regional studies (Ministry of Health, 2025). This study analyzes 1,739 hospitalizations for EP-TB in Rio Grande do Sul between 2013 and 2024, characterizing age distribution, length of hospital stay, and lethality, aiming to identify vulnerable groups and critical clinical patterns. Secondary data from DATASUS were analyzed, focusing on six forms of EP-TB. Descriptive and temporal analyses were performed, emphasizing age groups, mean length of hospital stay, and lethality rates. Age distribution revealed distinct patterns: adults aged 30–49 years accounted for 47% of hospitalizations (n=818), with predominance in the 40–44 age group (n=194), mainly due to miliary and genitourinary tuberculosis. Children under 5 years accounted for 5.5% of cases (n=96), with higher incidence in those aged 1–4 years (n=61), frequently associated with severe forms such as central nervous system tuberculosis. Older adults aged ≥65 years represented 12% of hospitalizations (n=212), with a notable number of octogenarians (n=38) presenting significant comorbidities. The mean length of hospital stay was 12.6 days, with critical variations: genitourinary TB required 14.9 days, central nervous system TB 14.7 days, while miliary TB required 11.7 days. Adults aged ≥80 years had a 28% longer hospital stay than the mean in 2024 (16.2 days). Overall lethality was 10% (174 deaths), with alarming disparities: miliary TB accounted for 63% of deaths (n=110), with a lethality rate of 13.9%, reaching 22.4% in 2024. Adults aged ≥80 years recorded a lethality rate of 16.2% in the same year. Children under 1 year showed a historical lethality of 16.7% (2013–2017). Mortality increased by 283% between 2015 (6 deaths) and 2024 (23 deaths), with post-pandemic acceleration. A three-phase profile was identified: young adults (30–49 years) bear the greatest disease burden, while children under 5 years and adults aged ≥80 years experience the worst outcomes. Miliary TB emerges as a highly lethal entity, requiring specific surveillance protocols. The marked increase in deaths after 2020, associated with prolonged hospitalizations among older adults, suggests an impact of pandemic-related disruptions in healthcare continuity. Recommendations include: 1) active screening for miliary TB at the extremes of age; 2) training to support early diagnosis of genitourinary TB and CNS TB; 3) investigation of the determinants underlying the increased mortality.