Factors associated with post-treatment resorption of lung cavities in individuals with first episodes of drug-sensitive cavitary pulmonary tuberculosis in China.

BACKGROUND

In patients with pulmonary tuberculosis (TB), the persistence of the lung cavities leads to opportunistic infections and increases the risk of person-to-person Mycobacterium tuberculosis (Mtb) transmission. However, factors that associated with cavity resorption remain unknown.

METHODS

In this retrospective study, 588 patients with drug-sensitive pulmonary tuberculosis and cavitary lesions on chest imaging were enrolled. All patients completed a standard 6-month anti-tuberculosis drug treatment regimen. They were randomly divided into a training set (n = 412) and a validation set (n = 176) in a 7:3 ratio. Clinical variables including demographic data, radiological findings, laboratory test results, and anti-tuberculosis drug usage were collected. Univariate and multivariate logistic regression analyses were performed to identify factors associated with cavity absorption.

RESULTS

Multivariate logistic regression identified several factors independently associated with poor cavity resorption: older age (odds ratio [OR] 1.029, 95% confidence interval [CI]: 1.012-1.047), male sex (OR 2.599, CI: 1.349-5.009), serum total protein (OR 0.963, CI: 0.931-0.997), presence of multiple cavities (OR 1.791, CI: 1.115-2.876) and absence of fever (OR 1.729, CI: 1.032-2.893). The predictive model constructed using these six variables showed good discrimination, with an area under the curve (AUC) of 0.749 (95% CI: 0.699-0.798) in the training set and 0.746 (95% CI: 0.670-0.822) in the validation set (n = 176).

CONCLUSIONS

Our findings indicate that older age, male sex, lower serum total protein, presence of multiple cavities, and absence of fever are independently associated with poor cavity resorption in patients with pulmonary tuberculosis. These variables may help identify high-risk patients and guide personalized management. Therefore, for better control of Mtb infection and improved outcomes, greater clinical attention should be paid to these associated factors.