Pulmonary Impairment in Tuberculosis Survivors: The Korean National Health and Nutrition Examination Survey 2008-2012.
OBJECTIVE
Pulmonary tuberculosis (TB) can affect lung function, but studies regarding long-term follow-up in patients with no sequelae on chest X-ray (CXR) have not been performed. We evaluated lung functional impairment and persistent respiratory symptoms in those with prior pulmonary TB and those with prior pulmonary TB with no residual sequelae on CXR, and determined risk factors for airflow obstruction.


METHODS
We used data from adults aged ≥ 40 years from the annual Korean National Health and Nutrition Examination Surveys conducted between 2008 and 2012. P values for comparisons were adjusted for age, sex, and smoking status.


RESULTS
In total of 14,967 adults, 822 subjects (5.5%) had diagnosed and treated pulmonary TB (mean 29.0 years ago). The FVC% (84.9 vs. 92.6), FEV1% (83.4 vs. 92.4), and FEV1/FVC% (73.4 vs. 77.9) were significantly decreased in subjects with prior pulmonary TB compared to those without (p < 0.001, each). In 12,885 subjects with no sequalae on CXR, those with prior pulmonary TB (296, 2.3%) had significantly lower FEV1% (90.9 vs. 93.4, p = 0.001) and FEV1/FVC% (76.6 vs. 78.4, p < 0.001) than those without. Subjects with prior pulmonary TB as well as subjects with no sequalae on CXR were more likely to experience cough and physical activity limitations due to pulmonary symptoms than those without prior pulmonary TB (p < 0.001, each). In total subjects, prior pulmonary TB (OR, 2.314; 95% CI, 1.922-2.785), along with age, male, asthma, and smoking mount was risk factor for airflow obstruction. In subjects with prior pulmonary tuberculosis, inactive TB lesion on chest x-ray (OR, 2.300; 95% CI, 1.606-3.294) were risk factors of airflow obstruction.


CONCLUSIONS
In addition to subjects with inactive TB lesion on CXR, subjects with no sequelae on CXR can show impaired pulmonary function and respiratory symptoms. Prior TB is a risk factor for airflow obstruction and that the risk is more important when they have inactive lesions on chest X-ray. Hence, the patients with treated TB should need to have regular follow-up of lung function and stop smoking for early detection and prevention of the chronic airway disease.
Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Jae-Woo
JW
Jung
Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Jae-Chol
JC
Choi
Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Jong-Wook
JW
Shin
Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Jae-Yeol
JY
Kim
Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Byoung-Whui
BW
Choi
Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea.
In-Won
IW
Park
D000368:Aged; D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D017741:Survivors; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D014797:Vital Capacity