老年耐多药/利福平耐药肺结核患者的治疗转归及影响因素研究——全国多中心、回顾性队列研究OA北大核心CSTPCD

Objective:To analyze treatment outcomes and influencing factors of multidrug/rifampicin-resistant pulmonary tuberculosis(MDR/RR-PTB)in elderly patients.Methods:A national multicenter retrospective cohort study was conducted to include 475 elderly(≥60 years)MDR/RR-PTB patients who were admitted to six provincial tuberculosis hospitals from January 1,2018 to December 31,2020.Clinical characteristics of those patients were recorded and full course treatment was followed up.Multivariable logistic regression model was used to analyze factors affecting treatment outcomes.Results:Successful treatment rate of 475 elderly MDR/RR-PTB patients was 65.89％(313/475),cure rate and treatment completion rate were 50.74％(241/475)and 15.16％(72/475)respectively.Treatment failure rate was 13.05％(62/475),loss of follow-up rate was 17.05％(81/475)and mortality rate was 4.00％(19/475).Multivariable logistic regression analysis showed that 70-79 years old(OR=1.560,95％CI:1.001-2.431),≥80 years old(OR=3.306,95％CI:1.370-7.974),lung cavities(OR=1.832,95％CI:1.195-2.808)were risk factors affecting MDR/RR-PTB treatment success in elderly patients.Inclusion of Bedaquiline in treatment regimen(OR=0.193,95％CI:0.044-0.841)was a protective factor for successful treatment.Conclusion:The treatment of elderly MDR/RR-PTB patients is complicated and difficult for which the successful treatment rate is low.Special attention should be paid to elderly patients aged ≥70 years and those with pulmonary cavities.