Risk factors of unfavourable treatment outcomes in patients with rifampicin-sensitive pulmonary tuberculosis
10.3760/cma.j.issn.1674-2397.2024.06.006
- VernacularTitle:利福平敏感肺结核患者不良治疗结局的危险因素分析
- Author:
Luyi LYU
1
;
Ling YE
;
Jianhua LAN
;
Min FANG
;
Tao WANG
;
Zhiyu WU
;
Shugen WU
;
Weili LU
;
Chunxian PENG
;
Tao LU
Author Information
1. 浙江中医药大学第二临床医学院,杭州310053
- Publication Type:Journal Article
- Keywords:
Pulmonary tuberculosis;
Rifampicin;
Treatment outcome;
Risk factors
- From:
Chinese Journal of Clinical Infectious Diseases
2024;17(6):449-456
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors of unfavourable treatment outcomes in patients with rifampicin-sensitive pulmonary tuberculosis(PTB).Methods:Clinical data of 726 patients with rifampicin-sensitive PTB admitted in Quzhou Hospital Affiliated to Wenzhou Medical University from January 2020 to December 2021 were retrospectively analyzed,including 628 cases with favourable treatment outcomes(favourable group)and 98 cases with unfavourable treatment outcomes(unfavourable group). After excluding the lost to follow-up cases and non-tuberculosis-related death cases,there were 659 survival cases(survival group)and 16 cases of tuberculosis-related death(fatal group). Univariate and multivariate Logistic regression were used to analyze the related risk factors.Results:Among 98 cases with unfavourable treatment outcomes,42 cases died from non-tuberculosis causes,32 cases lost follow-up,16 cases died from tuberculosis and 8 cases had failed treatment. Multivariate Logistic regression analysis showed that age≥60( OR=2.515,95% CI 1.461-4.330),retreatment of tuberculosis( OR=2.502,95% CI 1.255-4.989),chronic obstructive pulmonary disease( OR=2.796,95% CI 1.607-4.865),respiratory failure( OR=6.373,95% CI 2.320-17.506),hypoproteinemia( OR=3.149,95% CI 1.876-5.286)and elevated C-reactive protein( OR=1.007,95% CI 1.002-1.012)were independent risk factors for unfavorable treatment outcomes in rifampicin-sensitive PTB patients(all P<0.01);retreated pulmonary tuberculosis( OR=4.542,95% CI 1.182-17.449),complicated respiratory failure( OR=14.186,95% CI 3.038-66.252)and body mass index<18.5 kg/m 2( OR=5.179,95% CI 1.333-20.119)were independent risk factors for poor prognosis in rifampicin-sensitive PTB patients( P<0.05 or <0.01). Conclusion:The older age,low BMI,hypoproteinemia,elevated C-reactive protein,comorbidities and retreatment are risk factors for unfavorable treatment outcomes and poor prognosis in patients with rifampicin-sensitive PTB.