Clinical Factors Associated with Cavitary Tuberculosis and Its Treatment Outcomes

Cavitary pulmonary tuberculosis (TB) is associated with poor outcomes, treatment recurrence, higher transmission rates, and the development of drug resistance. However, reports on its clinical characteristics, associated factors, and treatment outcomes are lacking. Hence, this study sought to evalua...

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Autores principales:	Sun-Hyung Kim, Yoon Mi Shin, Jin Young Yoo, Jun Yeun Cho, Hyeran Kang, Hyun Lee, Kang Hyeon Choe, Ki Man Lee, Bumhee Yang
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	tuberculosis cavity association factors treatment outcomes Medicine R
Acceso en línea:	https://doaj.org/article/789bcc0c6927495dbadb1853c2085f41
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spelling	oai:doaj.org-article:789bcc0c6927495dbadb1853c2085f412021-11-25T18:06:59ZClinical Factors Associated with Cavitary Tuberculosis and Its Treatment Outcomes10.3390/jpm111110812075-4426https://doaj.org/article/789bcc0c6927495dbadb1853c2085f412021-10-01T00:00:00Zhttps://www.mdpi.com/2075-4426/11/11/1081https://doaj.org/toc/2075-4426Cavitary pulmonary tuberculosis (TB) is associated with poor outcomes, treatment recurrence, higher transmission rates, and the development of drug resistance. However, reports on its clinical characteristics, associated factors, and treatment outcomes are lacking. Hence, this study sought to evaluate the clinical factors associated with cavitary pulmonary TB and its treatment outcomes. We retrospectively evaluated 410 patients with drug-susceptible pulmonary TB in a university hospital in Korea between 2014 and 2019. To evaluate the factors associated with cavitary TB, multivariable logistic regression was performed with adjustments for potential confounders. We also compared the treatment outcomes between patients with cavitary TB and those without cavitary TB. Of the 410 patients, 244 (59.5%) had non-cavitary TB and 166 (40.5%) had cavitary TB. Multivariable logistic analysis with forward selection method showed that body mass index (BMI) (adjusted OR = 0.88, 95% CI: 0.81–0.97), previous history of TB (adjusted OR = 3.45, 95% CI: 1.24–9.59), ex- or current smoker (adjusted OR = 1.77, 95% CI: 1.01–3.13), diabetes mellitus (adjusted OR = 2.72, 95% CI: 1.36–5.44), and positive results on the initial sputum acid-fast bacilli (AFB) smear (adjusted OR = 2.24, 95% CI: 1.26–3.98) were significantly associated with cavitary TB. Although treatment duration was significantly longer in patients with cavitary TB than in those with non-cavitary TB (248 (102–370 days) vs. 202 (98–336 days), <i>p</i> < 0.001), the recurrence rate after successful treatment was significantly higher in the patients with cavitary TB than in those with non-cavitary TB (0.4% vs. 3.0% <i>p</i> = 0.042). In conclusion, ex- or current smoker, lower BMI, previous history of TB, diabetes mellitus, and positivity of the initial AFB smear were associated with cavitary TB. The patients with cavitary TB had more AFB culture-positive results at 2 months, longer treatment duration, and higher recurrence rates than those with non-cavitary TB.Sun-Hyung KimYoon Mi ShinJin Young YooJun Yeun ChoHyeran KangHyun LeeKang Hyeon ChoeKi Man LeeBumhee YangMDPI AGarticletuberculosiscavityassociation factorstreatment outcomesMedicineRENJournal of Personalized Medicine, Vol 11, Iss 1081, p 1081 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tuberculosis cavity association factors treatment outcomes Medicine R
spellingShingle	tuberculosis cavity association factors treatment outcomes Medicine R Sun-Hyung Kim Yoon Mi Shin Jin Young Yoo Jun Yeun Cho Hyeran Kang Hyun Lee Kang Hyeon Choe Ki Man Lee Bumhee Yang Clinical Factors Associated with Cavitary Tuberculosis and Its Treatment Outcomes
description	Cavitary pulmonary tuberculosis (TB) is associated with poor outcomes, treatment recurrence, higher transmission rates, and the development of drug resistance. However, reports on its clinical characteristics, associated factors, and treatment outcomes are lacking. Hence, this study sought to evaluate the clinical factors associated with cavitary pulmonary TB and its treatment outcomes. We retrospectively evaluated 410 patients with drug-susceptible pulmonary TB in a university hospital in Korea between 2014 and 2019. To evaluate the factors associated with cavitary TB, multivariable logistic regression was performed with adjustments for potential confounders. We also compared the treatment outcomes between patients with cavitary TB and those without cavitary TB. Of the 410 patients, 244 (59.5%) had non-cavitary TB and 166 (40.5%) had cavitary TB. Multivariable logistic analysis with forward selection method showed that body mass index (BMI) (adjusted OR = 0.88, 95% CI: 0.81–0.97), previous history of TB (adjusted OR = 3.45, 95% CI: 1.24–9.59), ex- or current smoker (adjusted OR = 1.77, 95% CI: 1.01–3.13), diabetes mellitus (adjusted OR = 2.72, 95% CI: 1.36–5.44), and positive results on the initial sputum acid-fast bacilli (AFB) smear (adjusted OR = 2.24, 95% CI: 1.26–3.98) were significantly associated with cavitary TB. Although treatment duration was significantly longer in patients with cavitary TB than in those with non-cavitary TB (248 (102–370 days) vs. 202 (98–336 days), <i>p</i> < 0.001), the recurrence rate after successful treatment was significantly higher in the patients with cavitary TB than in those with non-cavitary TB (0.4% vs. 3.0% <i>p</i> = 0.042). In conclusion, ex- or current smoker, lower BMI, previous history of TB, diabetes mellitus, and positivity of the initial AFB smear were associated with cavitary TB. The patients with cavitary TB had more AFB culture-positive results at 2 months, longer treatment duration, and higher recurrence rates than those with non-cavitary TB.
format	article
author	Sun-Hyung Kim Yoon Mi Shin Jin Young Yoo Jun Yeun Cho Hyeran Kang Hyun Lee Kang Hyeon Choe Ki Man Lee Bumhee Yang
author_facet	Sun-Hyung Kim Yoon Mi Shin Jin Young Yoo Jun Yeun Cho Hyeran Kang Hyun Lee Kang Hyeon Choe Ki Man Lee Bumhee Yang
author_sort	Sun-Hyung Kim
title	Clinical Factors Associated with Cavitary Tuberculosis and Its Treatment Outcomes
title_short	Clinical Factors Associated with Cavitary Tuberculosis and Its Treatment Outcomes
title_full	Clinical Factors Associated with Cavitary Tuberculosis and Its Treatment Outcomes
title_fullStr	Clinical Factors Associated with Cavitary Tuberculosis and Its Treatment Outcomes
title_full_unstemmed	Clinical Factors Associated with Cavitary Tuberculosis and Its Treatment Outcomes
title_sort	clinical factors associated with cavitary tuberculosis and its treatment outcomes
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/789bcc0c6927495dbadb1853c2085f41
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Clinical Factors Associated with Cavitary Tuberculosis and Its Treatment Outcomes

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