Analysis of Drug Resistance Risk Factors and Construction and Validation of a Stratified Prediction Model in Elderly Patients with Pulmonary Tuberculosis
10.13241/j.cnki.pmb.2025.16.007
- VernacularTitle:老年人群肺结核耐药风险因素分析与分层预测模型的构建及验证
- Author:
Rui KANG
1
;
Gai-yan REN
;
Yang-yang YAO
;
Yan-mei ZHAO
;
Fen-fen WANG
Author Information
1. 延安市第二人民医院呼吸结核科 陕西延安 716000;延安大学附属医院呼吸内科 陕西延安 716000
- Publication Type:Journal Article
- Keywords:
Elderly population;
Pulmonary tuberculosis;
Drug resistance;
Risk factors;
Prediction model
- From:
Progress in Modern Biomedicine
2025;25(16):2622-2629
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the drug resistance status and related risk factors in elderly patients with pulmonary tuberculosis,and to construct and validate a drug resistance risk prediction model for elderly pulmonary tuberculosis patients,providing evidence for early clinical identification of high-risk populations.Methods:A retrospective study was conducted,consecutively enrolling 315 pulmonary tuberculosis patients aged ≥60 years from January 2019 to December 2021.Based on drug susceptibility test results,patients were divided into drug-resistant group(85 cases)and drug-sensitive group(230 cases).Data on demographic characteristics,clinical manifestations,comorbidities,imaging features,and previous treatment history were collected.Univariate and multivariate logistic regression analyses were performed to identify drug resistance-related factors,and a prediction model was constructed accordingly.The model was internally validated using the concordance index(C-index)and Bootstrap method.Results:Among 315 elderly pulmonary tuberculosis patients,the drug resistance rate was 26.98％,predominantly mono-resistance(48.24％)and multidrug-resistance(28.24％).Multivariate logistic regression analysis showed that previous anti-tuberculosis treatment history[OR=4.537,95％CI(1.962-10.498),P=0.005],diabetes mellitus[OR=3.286,95％CI(1.547-6.979),P=0.002],pulmonary cavitation[OR=4.158,95％CI(1.926-8.973),P＜0.001],pleural effusion[OR=2.563,95％CI(1.218-5.390),P=0.013],and tracheobronchial tuberculosis[OR=2.819,95％CI(1.352-5.876),P=0.006]were independent risk factors for drug resistance in elderly pulmonary tuberculosis.The prediction model constructed based on these factors had a C-index of 0.815(95％CI:0.762-0.868).Conclusion:The drug resistance rate is high among elderly pulmonary tuberculosis patients.Previous anti-tuberculosis treatment history,diabetes mellitus,pulmonary cavitation,pleural effusion,and tracheobronchial tuberculosis are independent risk factors for drug resistance in elderly pulmonary tuberculosis.The prediction model constructed based on these factors has good predictive value for identifying high-risk populations,which is helpful for early clinical intervention and individualized treatment strategy formulation.
