Baseline Predictors of Unfavorable Outcome in Pulmonary Tuberculosis: a Multi-institutional Retrospective Study of 1,973 Patients
의약학 > 내과학
권용수 , 김이형 , 송재욱 , 김호철 , 고원중 , 전경만 , 송준휘 , 류연주 , 김우열 , 최재철 , 박소영
대한결핵 및 호흡기학회
대한결핵및호흡기학회 추계학술발표초록집 2012년, 제114권 156(총1페이지)
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    Objective; To evaluate the baseline predictors of treatment outcome in patients with pulmonary tuberculosis (TB). Methods: We retrospectively reviewed the cohort of 2713 patients who were suspected of having active TB and received anti-TB therapy in 10 teaching hospitals from Jan. 2009 to Dec. 2009. Results: Of all patients, we excluded 740 patients with extrapulmonary TB (n=504), changing their final diagnosis (n=156), known multi-drug resistant TB who received 2nd-line anti-TB drugs at the start of treatment (n=18), insufficient data for treatment outcomes (n=59) and others (n=3). Finally 1973 patients were enrolled (age=50±19, male=57%). The favorable outcome including cured or completed therapy was achieved for 78% of all patients. Male, elderly (≥65), ever smoking, bilateral lung involvement, positive sputum AFB stain at the start of treatment, previous TB treatment, and co-morbid conditions: diabetes, neurologic disease, lung cancer, and other solid organ tumors except lung cancer were associated with unfavorable outcome in univariate analysis. However, elderly (odd ratio [OR]=2.5, 95% confidence interval [CI] 1.8-3.3), ever smoking (OR=2.5, 95% CI 1.7-3.6), bilateral lung involvement (OR=1.5, 95% CI 1.1-2.1), previous TB treatment (OR=1.8, 95% CI 1.3-2.5), and combined neurologic disease (OR=2.4, 95% CI 1.2-4.8) were independent predictors of unfavorable outcome in multivariate analysis. Conclusion: Elderly, ever smoking, bilateral lung involvement, previous TB treatment, and combined neurologic disease could be baseline prognostic factors for pulmonary TB.
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