A Clinical Prediction Model for Unsuccessful Pulmonary Tuberculosis Treatment Outcomes

Abstract

Methods: Data originated from the Regional Prospective Observational Research for Tuberculosis Brazil cohort (2015–2019). This analysis included participants with culture-confirmed, drug-susceptible pulmonary TB who started first-line therapy. The end point was unsuccessful TB treatment, a composite of death, treatment failure, regimen switch, incomplete treatment, or not evaluated. Predictors were chosen via bootstrapped backward selection.

Results: Of 944 participants, 191 (20%) had unsuccessful treatment outcomes. The final model included 7 baseline predictors: hemoglobin, HIV infection, drug use, diabetes, age, education, and tobacco use. The model demonstrated good discrimination (c-statistic = 0.77) and was well calibrated. HIV-related factors and isoniazid acetylation status did not improve the final model’s prediction.

Conclusions: Using information readily available at treatment initiation, the prediction model performed well in this population. The findings may guide future work to allocate resources or inform targeted interventions for high-risk patients.

Keywords: pulmonary tuberculosis; prognosis; prediction model; epidemiologic research; HIV coinfection.

Clique aqui

• Data de Publicação: 02/07/2021
• Autores: Lauren S Peetluk , Peter F Rebeiro, Felipe M Ridolfi, Bruno B Andrade, Marcelo Cordeiro-Santos, Afranio Kritski, Betina Durovni, Solange Calvacante, Marina C Figueiredo, David W Haas