Clinical predictors of tracheobronchial tuberculosis and associated airway stenosis among patients with pulmonary tuberculosis: a study from Southwestern China

Abstract

To investigate the clinical characteristics and predictors of tracheobronchial tuberculosis (TBTB) in southwestern China. This single-centre retrospective study included 1,999 patients with confirmed PTB who presented to the outpatient or inpatient departments of West China Hospital between September 2013 and June 2019, underwent bronchoscopy, and had complete baseline clinical data available. Patients with PTB complicated by TBTB were assigned to the case group, while patients with PTB without TBTB were allocated to the control group.Logistic regression analysis was carried out to identify predictors of TBTB and tracheobronchial stenosis. Among the 1,999 included patients with PTB who underwent bronchoscopy and had complete baseline data, 439 (22.0%) were diagnosed with TBTB, whereas 1,560 (78.0%) had no bronchoscopic evidence of TBTB. Multivariable logistic regression analysis identified female sex (odds ratio [OR]: 5.726, 95% confidence interval [CI]: 1.913–17.133; p = 0.002), age < 50 years (OR: 4.144, 95% CI: 1.791–9.588; p = 0.001), and positive sputum acid-fast smear (OR: 2.494, 95% CI: 0.998–6.636; p = 0.050) as independent predictors of TBTB. Among patients with TBTB, 218 (49.7%) developed airway stenosis. Among patients with PTB selected for bronchoscopy in southwestern China, TBTB was frequently identified and was commonly accompanied by airway stenosis. The observed proportion should not be generalized to the overall PTB population. Young to middle-aged female patients exhibiting positive sputum acid-fast smears, a significant predictor of TBTB, may derive substantial benefit from the prompt initiation of bronchoscopy at the time of PTB diagnosis.