UNASSIGNED: To investigate the incidence, factors, management, and impact of AEs on treatment outcomes in MDR-TB patients.
UNASSIGNED: This study reviewed the medical records of 275 MDR-TB patients at Fatimah Jinnah Institute of Chest Diseases in Quetta, Pakistan. Patient information was collected using a designed data collection form. Mann-Whitney U and Kruskal-Wallis tests examined the difference in AEs occurrences based on patients\' characteristics. Multiple binary logistic regression identified factors associated with unsuccessful outcomes, with statistical significance set at a p-value < 0.05.
UNASSIGNED: Almost all patients (99.6%) experienced at-least one AE (median = 4/patient, interquartile range:3-6). The most common were GI disturbance (95.3%), arthralgia (80.4%), body pain and headache (61.8%), ototoxicity (61.4%), psychiatric disturbance (44%), hypokalaemia (40.4%), dermatological reactions (26.2%) and hypothyroidism (21.5%). AEs led to treatment modification in 7.3% patients. Educated patients, those with a history of TB treatment, previous use and resistance to any second-line drug had significantly higher number of AEs. A total of 64.0% were declared cured, 3.6% completed treatment, 19.6% died and 12.7.9% were lost to follow-up. Patients\' age of 41-60(OR = 9.225) and >60 years(OR = 23.481), baseline body weight of 31-60 kg(OR = 0.180), urban residence(OR = 0.296), and experiencing ototoxicity (OR = 0.258) and hypothyroidism (OR = 0.136) were significantly associated with unsuccessful treatment outcomes.
UNASSIGNED: AEs were highly prevalent but did not negatively impact treatment outcomes. Patients at higher risk of developing AEs and unsuccessful outcomes should receive special attention for its early management.
■为了调查发病率,因素,管理,以及不良事件对耐多药结核病患者治疗结果的影响。
■这项研究回顾了奎达法蒂玛金纳胸部疾病研究所的275例耐多药结核病患者的医疗记录,巴基斯坦。使用设计的数据收集表收集患者信息。Mann-WhitneyU和Kruskal-Wallis检验根据患者特征检查了不良事件发生的差异。多元二元逻辑回归确定了与不成功结果相关的因素,具有统计学显著性的p值<0.05。
■几乎所有患者(99.6%)都经历了至少一次AE(中位数=4/患者,四分位数间距:3-6)。最常见的是胃肠道紊乱(95.3%),关节痛(80.4%),身体疼痛和头痛(61.8%),耳毒性(61.4%),精神病(44%),低钾血症(40.4%),皮肤反应(26.2%)和甲状腺功能减退(21.5%)。AEs导致7.3%患者的治疗改变。受过教育的患者,那些有结核病治疗史的人,既往使用和对任何二线药物耐药的AEs明显增多.共有64.0%被宣布治愈,3.6%完成治疗,19.6%死亡,12.7.9%失访。患者年龄41-60(OR=9.225)和>60岁(OR=23.481),基线体重31-60公斤(OR=0.180),城市住宅(OR=0.296),并且经历耳毒性(OR=0.258)和甲状腺功能减退(OR=0.136)与不成功的治疗结果显著相关.
■不良事件非常普遍,但对治疗结果没有负面影响。发生AE的风险较高且结局不成功的患者应特别注意其早期管理。