Factors influencing poor long-term outcomes in tuberculous pleurisy patients: A 9-year cohort study

OBJECTIVES: To identify risk factors associated with poor long-term outcomes in patients with tuberculous pleurisy (TP) through a 9-year prospective cohort study. METHODS: From May 2014 to November 2018, a total of 464 patients diagnosed with TP were enrolled at Beijing Chest Hospital and followed up until November 2023, with a median follow-up duration of 7.1 years. Poor outcomes were defined as the occurrence of secondary empyema, recurrent pulmonary tuberculosis, or recurrent TP. Cox proportional hazards regression models were used to analyze prognostic factors associated with poor outcomes. RESULTS: Bilateral TP was independently associated with an increased risk of poor outcomes (adjusted hazard ratio [aHR], 2.68; 95% confidence interval [CI], 1.41-5.09, P = 0.003). Patients receiving extended anti-tuberculosis therapy also exhibited a significantly higher risk (aHR, 3.55; 95% CI, 2.05-6.15; P < 0.001). In contrast, standardized treatment was associated with a 93% reduction in the risk of poor outcomes compared with non-standardized treatment (aHR, 0.07; 95% CI, 0.02-0.24; P