Analysis of clinical characteristics and influencing factors of adverse treatment outcomes in 238 elderly patients with multidrug-resistant pulmonary tuberculosis
Objective To analyze the clinical characteristics and factors influencing adverse treatment outcomes in elderly patients with multidrug-resistant pulmonary tuberculosis(MDR-TB)to guide the clinical diagnosis and treatment of elderly MDR-TB patients.Methods Clinical data of elderly patients with multidrug-resistant pulmonary tuberculosis initially treated at Beijing Chest Hospital from 2008 to 2023 were retrospectively collected.Complications/comorbidities,adverse drug reactions,drug resistance during initial treatment,and retreatment were statistically described.Factors influencing adverse treatment outcomes were analyzed using the chi-square test and logistic regression analysis.Results A total of 238 elderly patients with MDR-TB were collected,of which 152(63.9％)had adverse drug reactions,184(77.3％)were retreated MDR-TB,27(11.3％)were extensively drug-resistant tuberculosis(XDR-TB),41 were cured,6 completed treatment,39 failed treatment,6 died,107 lost to follow-up,31 could not be evaluated,8 did not finish treatment,and the treatment success rate was 20.4％(47/230).The adverse outcome of treatment accounted for 79.6％(183/230).Univariate analysis showed that differences in age groups,the occurrence of drug adverse reactions,and patient sources had a statistically significant impact on treatment outcomes(P＜0.05).Logistic regression analysis was performed using good and adverse treatment outcomes as dependent variables for the three factors,which showed that being aged 70 and above,the occurrence of drug adverse reactions during treatment,and being a non-local patient were factors influencing adverse treatment outcomes[OR(95％CI):2.507(1.027-6.121),3.253(1.635-6.473),2.563(1.285-5.111),respectively].Conclusions Elderly patients with MDR-TB exhibit a high prevalence of complications/comorbidities,a high incidence of drug adverse reactions,and unfavorable treatment outcomes.Out-of-town medical treatment,advanced age,and experiencing drug adverse reactions are risk factors for adverse treatment outcomes.
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