Baseline Factors Associated with Long-Term Radiological Sequelae After Pulmonary Tuberculosis

Background and Aims: Long-term structural lung abnormalities may persist after successful treatment of pulmonary tuberculosis (TB). This study aimed to evaluate post-TB radiological sequelae and identify baseline factors independently associated with persistent structural lung damage.
Methods: This retrospective, single-center cohort study included 100 adults with pulmonary TB who completed treatment and underwent thoracic computed tomography at least six months later. Baseline demographic, clinical, microbiological, radiological, and available laboratory variables were compared between patients with and without radiological sequelae. Binary logistic regression was used to identify independently associated factors..
Results: Post-TB radiological sequelae were present in 67 patients (67.0%). Patients with sequelae were older and had higher frequencies of sputum smear positivity, culture positivity, baseline cavitation, and bilateral pulmonary involvement. Baseline disease extent showed a graded relationship with sequelae, which occurred in 20.0% of patients with 0–1 involved lobe, 71.1% with 2 involved lobes, and 94.6% with ≥3 involved lobes (p<0.001). In multivariable analysis, sputum smear positivity (adjusted OR 4.58, 95% CI 1.43–14.71; p=0.011) and the number of involved lung lobes (adjusted OR 6.51 per additional lobe, 95% CI 2.74–15.44; p<0.001) remained independently associated with radiological sequelae.
Conclusion: Greater baseline radiological extent and sputum smear positivity were independently associated with long-term post-TB structural lung abnormalities. Baseline disease burden may help identify patients who could benefit from closer respiratory assessment after treatment completion.