Study on the Association Network of Tuberculosis Lesions in Adult Extrapulmonary Tuberculosis in China: A Large‐Scale Multicenter Observational Study

<b>Background:</b> Extrapulmonary tuberculosis (EPTB) is a significant health problem which can lead to severe morbidity and mortality. In clinical practice, EPTB can have a variety of nonspecific clinical manifestations and can be concurrent with other types of EPTB. As information pertaining to concurrent EPTB is scarce, research efforts are needed to find concurrent EPTB types and to explore the association networks and rules of concurrent EPTB. <b>Materials and Methods:</b> An observational multicenter study was carried out at 21 hospitals from 15 provinces in China from Jan 1, 2011, to Dec 31, 2017. All the adult EPTB inpatients (≥ 15 years) were included. Multivariable logistic regression analysis was used to examine the associations of gender and age group for concurrent EPTB. The association network and rules for concurrent EPTB were analyzed by the Apriori algorithm. <b>Results:</b> A total of 75,993 adult EPTB inpatients (not including EPTB concurrent with PTB) were included. The ratio of male:female was 1.32. The most common types of EPTB lesions were tuberculous pleurisy (46.47%). In the fully adjusted multivariable logistic regression models, it was found that female EPTB patients (aOR = 1.129, 95% CI: 1.081-1.178) were more likely to have concurrent EPTB. As age increased, the risk of concurrent EPTB decreased (aOR < 1, <i>p</i> value for trend < 0.001). The association network graph showed that almost all the EPTB diseases may be concurrent with other types of EPTB. Ureteric tuberculosis and sacral tuberculosis diseases existed mainly in concurrence with other types of EPTB (about 80%). Tuberculous pleurisy and tuberculous lymphadenitis of the neck could be concurrent with more than 60 other types of EPTB disease. The most common concurrent EPTB types were tuberculous peritonitis concurrent with tuberculous pleurisy (1.64%). Sacral tuberculosis concurrentwith lumbar vertebra tuberculosis had the highest confidence value (68.56%). The strongest association rule was found for vesical tuberculosis concurrent with ureteric tuberculosis (lift = 166.18) and ureteric tuberculosis concurrent with vesical tuberculosis (lift = 166.18). <b>Conclusion:</b> The present study revealed the occurrence of concurrent EPTB types and analyzed the association network and rules among adult EPTB for the first time in a large sample population. Clinicians should be alert to the incidence of concurrent EPTB and that these patients require administration of customized treatment regimens in order to achieve the best outcomes.

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Journal
Canadian Journal of Infectious Diseases and Medical Microbiology
Published
2025-01-01
DOI
https://doi.org/10.1155/cjid/4944872
Primary Topic
Tuberculosis Research and Epidemiology
Type
article
Field-Weighted Citation Impact
0.00

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article

Study on the Association Network of Tuberculosis Lesions in Adult Extrapulmonary Tuberculosis in China: A Large‐Scale Multicenter Observational Study

Dan Lei, Wenge Han, Fujian Li, Zhiyi Yang et al.
Canadian Journal of Infectious Diseases and Medical Microbiology
Tuberculosis Research and Epidemiology
article

Study on the Association Network of Tuberculosis Lesions in Adult Extrapulmonary Tuberculosis in China: A Large‐Scale Multicenter Observational Study

Dan Lei, Wenge Han, Fujian Li, Zhiyi Yang, Xiaofeng Yan, Jianyong Zhang, Yongkang Dong, Qingyao Xie, A Ertai, Qiang Song, Zaoxian Mei, Wanli Kang, Yunqing Chang, Wenyu Cui, Xinguo Zhao, Lei Tan, L. Li, Shenjie Tang, Jinshan Ma, Shuliang Guo, Quanhong Wang, Qunyi Deng, Peijun Tang, Peilan Zong, Dawei Chen, Shengsheng Liu, Jian Zheng, Yingrong Du, Song‐I Yang, Liang Chen, Xiaohong Chen, Hongyan Chen, Pu Wang, Yuanyuan Li, Yi Zhang, Yuanyuan Liu, Jian Zhang, Ling Chen, Hongwei Liu, Yang Li, Mei Yang, Jian Du, Fenglin Liu, Wenyu Liu, Yanmei Feng, Meiying Wu, Xinghua Shen, Xinjie Li, Mingwu Li, Tong Ren, Lei Wu, Wei Shu, Jianxiong Liu, Chao Zheng, Junfeng Han, Xiangyang Yao, Youcai Li, Kun Yan, Jiajia Yu, Yangli Zhang, Jingmin Qin
article en

Abstract

<b>Background:</b> Extrapulmonary tuberculosis (EPTB) is a significant health problem which can lead to severe morbidity and mortality. In clinical practice, EPTB can have a variety of nonspecific clinical manifestations and can be concurrent with other types of EPTB. As information pertaining to concurrent EPTB is scarce, research efforts are needed to find concurrent EPTB types and to explore the association networks and rules of concurrent EPTB. <b>Materials and Methods:</b> An observational multicenter study was carried out at 21 hospitals from 15 provinces in China from Jan 1, 2011, to Dec 31, 2017. All the adult EPTB inpatients (≥ 15 years) were included. Multivariable logistic regression analysis was used to examine the associations of gender and age group for concurrent EPTB. The association network and rules for concurrent EPTB were analyzed by the Apriori algorithm. <b>Results:</b> A total of 75,993 adult EPTB inpatients (not including EPTB concurrent with PTB) were included. The ratio of male:female was 1.32. The most common types of EPTB lesions were tuberculous pleurisy (46.47%). In the fully adjusted multivariable logistic regression models, it was found that female EPTB patients (aOR = 1.129, 95% CI: 1.081-1.178) were more likely to have concurrent EPTB. As age increased, the risk of concurrent EPTB decreased (aOR < 1, <i>p</i> value for trend < 0.001). The association network graph showed that almost all the EPTB diseases may be concurrent with other types of EPTB. Ureteric tuberculosis and sacral tuberculosis diseases existed mainly in concurrence with other types of EPTB (about 80%). Tuberculous pleurisy and tuberculous lymphadenitis of the neck could be concurrent with more than 60 other types of EPTB disease. The most common concurrent EPTB types were tuberculous peritonitis concurrent with tuberculous pleurisy (1.64%). Sacral tuberculosis concurrentwith lumbar vertebra tuberculosis had the highest confidence value (68.56%). The strongest association rule was found for vesical tuberculosis concurrent with ureteric tuberculosis (lift = 166.18) and ureteric tuberculosis concurrent with vesical tuberculosis (lift = 166.18). <b>Conclusion:</b> The present study revealed the occurrence of concurrent EPTB types and analyzed the association network and rules among adult EPTB for the first time in a large sample population. Clinicians should be alert to the incidence of concurrent EPTB and that these patients require administration of customized treatment regimens in order to achieve the best outcomes.

Canadian Journal of Infectious Diseases and Medical MicrobiologyVol. 2025(1)
Xinjiang Medical University (CN), Capital Medical University (CN), Beijing Chao-Yang Hospital, Capital Medical University (CN), First Affiliated Hospital of Xiamen University (CN), Kunming Third People's Hospital (CN), Beijing Chest Hospital (CN), Heilongjiang Center for Tuberculosis Control and Prevention (CN), Jilin City Central Hospital (CN), Weifang People's Hospital (CN), Jiangxi Chest Hospital (CN), Changchun Obstetrics and Gynecology Hospital (CN), Fuzhou Pulmonary Hospital of Fujian (CN), Wuxi No.2 People's Hospital (CN), Anhui Provincial Hospital (CN), The Affiliated Yongchuan Hospital of Chongqing Medical University (CN), Shenyang 242 Hospital (CN), Shandong Chest Hospital (CN), Sixth Affiliated Hospital of Xinjiang Medical University (CN), Beijing Tsinghua Chang Gung Hospital (CN), Chongqing Public Health Medical Center (CN), Guangzhou Chest Hospital (CN), Wuxi People's Hospital (CN), Shanxi Academy of Medical Sciences (CN), Fourth People's Hospital of Taiyuan (CN), Third People's Hospital of Yunnan Province (CN), Affiliated Hospital of Zunyi Medical College (CN), Tianjin haihe hospital (CN), The Fifth People’s Hospital of Suzhou (CN), Shenzhen Third People’s Hospital (CN), Baoding People's Hospital (CN), Chongqing Medical University (CN)
National Key Research and Development Program of China
Good health and well-being
Openalex Percentile: Top 86%
Tuberculosis Research and Epidemiology
DOIOpen Access PDFOpenAlex
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