Prognostic factors for surgical resection in patients with multidrug-resistant tuberculosis

¹ Division of Pulmonary and Critical Care Medicine, Dept of Internal Medicine and Lung Institute, Dept of Thoracic and Cardiovascular Surgery Seoul National University College of Medicine, Seoul, Republic of Korea; Dept of Internal Medicine, Dept of Thoracic and Cardiovascular Surgery and Respiratory Center, Seoul National University Bundang Hospital, Gyeonggi-Do, Republic of Korea

^* To whom correspondence should be addressed. E-mail: yimjj{at}snu.ac.kr.

	Abstract

Although surgical lung resection could improve prognosis in some patients with MDR-TB, there are no reports on the optimal candidates for this surgery. The aim of this study was to elucidate the prognostic factors for surgery in patients with MDR-TB.

Patients who underwent lung resection for the treatment of MDR-TB between March 1993 and December 2004 were included. Treatment failure was defined as two or more of the five cultures recorded in the final 12 months of treatment being positive, any one of the final three cultures being positive, or having died during treatment. We identified the variables that affected treatment outcomes through univariate and multivariate logistic regression analysis.

79 patients with MDR-TB were included. The treatment outcomes of 22 patients (27.8%) were classified as failure. Body mass index lower than 18.5 kg·m^-2 (P=0.04), primary resistance (P<0.001), resistance to ofloxacin (P=0.048), and the presence of a cavitary lesion beyond the range of the surgical resection (P<0.001) were associated with treatment failure.

Low body mass index, primary resistance, resistance to ofloxacin, and cavitary lesions beyond the range of resection are possible poor prognostic factors for surgical lung resection in MDR-TB patients.

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