Chest CT findings in drug-resistant pulmonary tuberculosis: a comparative analysis of elderly and non-elderly patients.

BACKGROUND: Drug-resistant pulmonary tuberculosis (DR-TB) remains a critical public health challenge, particularly affecting vulnerable populations such as the elderly, who exhibit higher morbidity and mortality rates. This study aims to elucidate the chest CT characteristics of DR-TB in elderly patients to improve diagnostic accuracy and guide individualized treatment strategies.

METHODS: A retrospective analysis of 183 confirmed DR-TB cases (Huai'an Infectious Disease Hospital, June 2013-June 2023) compared chest CT findings (lesion distribution, extent, and morphology) between elderly patients (≥ 60 years) and non-elderly patients (14-59 years).

RESULTS: Key findings reveal that elderly patients demonstrate a higher frequency of extensive lung involvement, with 76% exhibiting lesions in all lung lobes compared to 40.74% in the non-elderly group (P&#x2009;<&#x2009;0.001). Additionally, the elderly group displayed significantly more pathological features, such as segmental and lobar shadows (61.33% vs. 45.37%, P&#x2009;=&#x2009;0.033) and lung destruction (22.67% vs. 11.11%, P&#x2009;=&#x2009;0.035).

CONCLUSION: The identification of risk factors on chest CT, including the presence of pulmonary and bronchial lesions, highlights the necessity for tailored screening and management strategies for elderly DR-TB patients.