Abstract:

Objective: To investigate the nutritional status of drug-resistant pulmonary tuberculosis patients and analyze the influencing factors. Methods: A retrospective study was conducted in 1766 drug-resistant pulmonary tuberculosis patients from 29 tuberculosis specialized hospitals in 17 provinces and 2 municipalities of China from January 1, 2020 to December 31, 2021. The age range of the patients was 18 to 90 years with the average age of (45.88±16.43) years, and the average body mass index (BMI) was 20.03±3.25. Among them, 1255 were male (71.06%) and 511 were female (28.94%). Demography information and clinical characteristics of the subjects were collected. The Nutritional Risk Screening-2002 (NRS-2002) was used to assess whether the subjects were at nutritional risk. Further assessment and diagnosis of malnutrition were conducted in accordance with the Global Leadership Initiative on Malnutrition (GLIM) standards. Multivariate logistic regression analysis was used to investigate the influencing factors of nutritional risk in drug-resistant pulmonary tuberculosis patients. Results: The NRS-2002 score of 1766 subjects fluctuated from 1 to 5, and the median score (Quartile) was 3 (1 to 4) points. A total of 1103 cases (62.46%) of the subjects had nutritional risks (NRS-2002 score ≥3 points). In the NRS-2002 score ≥3 group, 70.56% (254/360) of the patients aged 60-79 years old, 83.33% (25/30) aged ≥80 years old, and BMI of all the patients (100.0% (602/602)) <18.5, which were significantly higher than those in the NRS-2002 score <3 group (accounted for 29.44% (106/360), 16.67% (5/30), and 0, respectively)(χ² values were 6.256 and 1345.000, respectively; P values were 0.012 and <0.01). Multivariate logistic regression analysis showed that older age (with 18-39 years old group as reference, 60-79 years old group: OR (95%CI)=2.130 (1.194-3.803); ≥80 years old group: OR (95%CI)=12.400 (3.114-49.369)) and lower BMI (with BMI ≥20.5 as reference, BMI <18.5: OR (95%CI)=56.937 (26.537-122.161)) were risk factors for nutritional risk in drug-resistant pulmonary tuberculosis patients. The incidence of malnutrition among the study subjects was 52.55% (928/1766). Among 1103 individuals at risk for nutrition, the incidence of malnutrition was 84.13% (928/1103). Conclusion: Drug-resistant pulmonary tuberculosis patients have a higher nutritional risk and a higher incidence of malnutrition. Therefore, it is necessary to conduct standardized nutritional risk screening and diagnosis of malnutrition for such patients as early as possible, with special attention paid to elder and low BMI patients.

Key words: Tuberculosis, pulmonary, Drug resistance, Nutritional status, Malnutrition, Retrospective studies