Clinical characteristics and prognostic factors of pulmonary tuberculosis with interstitial changes.

Background: Pulmonary tuberculosis (PTB) remains a significant global public health challenge, particularly in its manifestation as interstitial lung disease. This form complicates clinical presentation, increasing the difficulty of diagnosis and treatment. However, studies on PTB with interstitial changes are relatively scarce, and their clinical significance and prognostic value have not been fully explored. The objective of the present study was to identify the key factors affecting clinical characteristics and prognosis in these patients.

Methods: This retrospective study analyzed data from patients diagnosed with PTB with Interstitial Changes at Zigong First People's Hospital in Sichuan Province between January 2014 and January 2024. Sixteen patients meeting strict inclusion and exclusion criteria were enrolled. Clinical characteristics and key prognostic factors were identified using descriptive statistics and random forest analysis, with partial dependence plots generated to illustrate the independent contributions of each variable to adverse outcomes.

Results: Among the 16 patients studied, 75.0% were male and 25.0% were female. The average number of pathogen species detected was 1.56 ± 0.73, and 31.3% of patients presented with fever symptoms at admission. Hospital stay durations ranged from 8 to 67 days, with a mean of 22.00 ± 16.02 days. Regarding drug resistance, 25.0% of patients exhibited rifampicin resistance, and approximately 31.2% had underlying diseases. Ultimately, 11 patients (68.8%) recovered, while 5 (31.2%) died. The random forest model identified age, rifampicin resistance, and the number of pathogen species as the main determinants of prognosis. Advanced age and drug resistance were significantly associated with a higher risk of death, and patients infected with multiple pathogens experienced worse outcomes.

Conclusions: This study enhances our understanding of the clinical characteristics and prognosis of tuberculosis patients presenting with interstitial lung disease, particularly identifying advanced age, rifampicin resistance, and a higher number of pathogen species as key prognostic factors. These findings provide valuable insights for the development of personalized treatment strategies and precision medicine approaches for this patient group.