Incidence and Outcomes of Post-Tuberculosis Airway Stenosis

BACKGROUND: Post-tuberculosis airway stenosis (PTAS) is an underrecognized complication among TB survivors, especially those with tracheobronchial tuberculosis (TBTB). This study aimed to evaluate the prevalence, clinical features, and long-term outcomes of PTAS in a large real-world cohort. METHODS: We conducted a retrospective cohort study of pulmonary TB patients treated between 2017 and 2022 in Shenzhen, China. PTAS was identified based on bronchoscopy, imaging, and symptom assessment. Clinical data, including modified Medical Research Council (mMRC) dyspnea scores, were collected at baseline and during follow-up. Bronchoscopic intervention outcomes were also evaluated. RESULTS: Among 25,896 pulmonary TB patients, 265 (1%) were diagnosed with PTAS. Of the 98 cases with complete follow-up, 48 (49%) were asymptomatic (mMRC rank 0), and none of them progressed during a median follow-up of 1451 days. Among the 50 symptomatic patients (mMRC rank 1 to 4), 12 (24%) showed clinical deterioration. Baseline symptom severity was significantly associated with disease progression (P<0.001). Bronchoscopic interventions provided symptom relief in most cases, although statistical significance for reduced disease progression was not achieved (P>0.05). CONCLUSION: In this real-world study conducted in southern China, PTAS are observed to be less common yet potentially progressive complications among tuberculosis survivors. These complications can significantly impact the quality of life. The risk of progression may be predicted by baseline airway obstruction scores, which could serve as a basis for developing intervention strategies.