Tuberculosis Development in Chronic Obstructive Pulmonary Disease: A Nationwide Population-Based Study.

BACKGROUND

Pulmonary tuberculosis is a major comorbidity of chronic obstructive pulmonary disease (COPD). However, the risk factors for tuberculosis development in patients with COPD have not been thoroughly studied. Thus, this study investigated the development of tuberculosis according to comorbidities and inhaler prescriptions for COPD.

METHODS

A retrospective cohort study was conducted using data from the Korean Health Insurance Review and Assessment Service database from January 1, 2015 to December 31, 2020. This cohort included 139,589 COPD patients (≥ 40 years) with a new prescription of inhalers. Cox proportional hazards regression models were used to identify significant risk factors for predicting the development of tuberculosis.

RESULTS

Multivariate analysis demonstrated that a history of tuberculosis (hazard ratio [HR], 18.14; 95% confidence interval [CI], 16.44-20.02) and hospitalization during the screening period (HR for one hospitalization, 1.30; 95% CI, 1.17-1.44; HR for two or more hospitalizations, 1.54; 95% CI, 1.39-1.70), along with older age and male sex, were associated with the development of pulmonary tuberculosis.

CONCLUSION

Our data indicate that a history of tuberculosis and hospitalization during the screening period, along with old age and male sex, are independent risk factors for the development of pulmonary tuberculosis in patients with COPD.