PREDICTORS OF ATYPICAL CHEST IMAGING IN PATIENTS WITH PULMONARY TUBERCULOSIS

Abstract

This study aimed to identify the risk factors associated with abnormal chest imaging in patients diagnosed with pulmonary tuberculosis. A retrospective study was conducted between December 2022 and December 2023 in the Radiology Department of Mayo Hospital, Lahore. The study included 100 patients who were diagnosed with smear-positive pulmonary tuberculosis and had undergone chest computed tomography (CT) within two weeks before or after hospital admission. Patients' performance status was assessed on a scale of 0-4. CT scans were performed on all patients, and radiologists were unaware of the patient's data. They examined the scans to determine the presence of lung involvement (upper, middle, and lower) and cavity. Out of 100 patients, 48 (48%) had non-cavity disease. Univariate analysis revealed that patients with non-cavity disease were most likely to be female, older, and have low estimated glomerular filtration rate (eGFR) and C-reactive protein (CRP) levels compared to patients with cavities. In multivariate analysis, low CRP levels were found to be the most potent risk factor for non-cavity disease after adjusting for co-variables. Additionally, 70 patients (70%) presented with non-upper predominant lung disease. Univariate analysis revealed that the majority of patients in this group were women and had high CRP levels, low albumin levels, and poor performance status. Poor performance status was the most potent risk factor for non-upper predominant lung disease. Based on the study findings, low C-reactive protein levels and poor performance status are the most substantial risk factors for non-cavity and non-upper predominant lung disease, respectively, in patients with pulmonary tuberculosis.