Clinical Factors Associated with Cavitary Tuberculosis and Its Treatment Outcomes

Sun-Hyung Kim; Yoon Mi Shin; Jin Young Yoo; Jun Yeun Cho; Hyeran Kang; Hyun Lee; Kang Hyeon Choe; Ki Man Lee; Bumhee Yang

doi:10.3390/jpm11111081

Clinical Factors Associated with Cavitary Tuberculosis and Its Treatment Outcomes

J Pers Med. 2021 Oct 25;11(11):1081. doi: 10.3390/jpm11111081.

Authors

Sun-Hyung Kim¹, Yoon Mi Shin¹, Jin Young Yoo², Jun Yeun Cho¹, Hyeran Kang¹, Hyun Lee³, Kang Hyeon Choe¹, Ki Man Lee¹, Bumhee Yang¹

Affiliations

¹ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, Korea.
² Department of Radiology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, Korea.
³ Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea.

Abstract

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), p < 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% p = 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.

Keywords: association factors; cavity; treatment outcomes; tuberculosis.

Abstract

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