Risk factors for the progression from pulmonary tuberculosis to spinal tuberculosis: a logistic regression analysis

Abstract Purpose This study aims to identify the risk factors for the progression from pulmonary tuberculosis (PTB) to spinal tuberculosis (STB), which is crucial for early disease intervention, optimizing treatment strategies, and improving patient prognosis. Methods A retrospective analysis was co...

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Main Authors: Di Xue, Xiaolei Chen, Lufei Shao, Qinfu Liu, Jia Chen, Yajing Su, Chen Zhang, Zhirong Chen, Min Su, Zhiqiang Wu, Yiqiang Yang, Xue Lin
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-05848-3
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author Di Xue
Xiaolei Chen
Lufei Shao
Qinfu Liu
Jia Chen
Yajing Su
Chen Zhang
Zhirong Chen
Min Su
Zhiqiang Wu
Yiqiang Yang
Xue Lin
author_facet Di Xue
Xiaolei Chen
Lufei Shao
Qinfu Liu
Jia Chen
Yajing Su
Chen Zhang
Zhirong Chen
Min Su
Zhiqiang Wu
Yiqiang Yang
Xue Lin
author_sort Di Xue
collection DOAJ
description Abstract Purpose This study aims to identify the risk factors for the progression from pulmonary tuberculosis (PTB) to spinal tuberculosis (STB), which is crucial for early disease intervention, optimizing treatment strategies, and improving patient prognosis. Methods A retrospective analysis was conducted on 326 patients diagnosed with PTB between January 2017 and October 2024. Demographic, clinical, and socioeconomic data were collected, including age, gender, body mass index (BMI), Karnofsky Performance Status (KPS), Nutritional Risk Screening 2002 (NRS-2002) score, diabetes, per capita income, smoking status, alcohol consumption, and a history of recurrent PTB. Univariate and multivariate logistic regression analyses were performed to identify significant risk factors for the progression to STB, and interaction effect analysis and risk stratification based on the NRS-2002 score were conducted to assess its predictive value. Results Univariate logistic regression revealed that the NRS-2002 score (OR = 2.762, p < 0.001), recurrent PTB (OR = 15.370, p < 0.001), and living in relative poverty (OR = 10.000, p = 0.002) were significant risk factors for the progression from PTB to STB. Multivariate logistic regression confirmed that the NRS-2002 score (OR = 11.22, p < 0.001), recurrent PTB (OR = 5.08, p < 0.001), and living in relative poverty (OR = 2.58, p < 0.001) were independently associated with increased likelihood of STB progression. Stratified analysis revealed a clear dose-response relationship between higher NRS-2002 scores and the risk of progression to STB, with those having scores ≥ 6 exhibiting the highest odds (OR = 91.59, p < 0.001). Conclusions This study highlights critical risk factors for the progression from PTB to STB, particularly the NRS-2002 score, recurrent PTB, and socioeconomic status (living in relative poverty). The NRS-2002 score was identified as the most significant predictor, demonstrating a strong dose-response relationship with disease progression. Clinically, early identification of patients with elevated NRS-2002 scores, alongside timely nutritional interventions and efforts to alleviate poverty, can significantly reduce the risk of STB development. These findings can inform clinical decision-making, enhance early intervention strategies, and guide public health policies aimed at preventing STB, particularly in high-risk populations.
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spelling doaj-art-cc6599eb13904a2899f041ec0ea8c09c2025-08-20T03:52:23ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-04-012011910.1186/s13018-025-05848-3Risk factors for the progression from pulmonary tuberculosis to spinal tuberculosis: a logistic regression analysisDi Xue0Xiaolei Chen1Lufei Shao2Qinfu Liu3Jia Chen4Yajing Su5Chen Zhang6Zhirong Chen7Min Su8Zhiqiang Wu9Yiqiang Yang10Xue Lin11Ningxia Key Laboratory of Clinical and Pathogenic Microbiology, Institute of Medical Sciences, General Hospital of Ningxia Medical UniversityThe Orthopaedic department, General Hospital of Ningxia Medical UniversityThe Neurology department, General Hospital of Ningxia Medical UniversityThe ICU department General Hospital of Ningxia Medical UniversityDepartment of Orthodontics, Stomatological Hospital, General Hospital of Ningxia Medical UniversityNingxia Key Laboratory of Clinical and Pathogenic Microbiology, Institute of Medical Sciences, General Hospital of Ningxia Medical UniversitySchool of Education, Ningxia UniversityThe Orthopaedic department, General Hospital of Ningxia Medical UniversityDepartment of Orthopaedics, The First Affiliated Hospital of Fujian Medical UniversityDepartment of Orthopedics, Quanzhou Orthopedic-Traumatological HospitalDepartment of Orthodontics, Stomatological Hospital, General Hospital of Ningxia Medical UniversityNingxia Key Laboratory of Clinical and Pathogenic Microbiology, Institute of Medical Sciences, General Hospital of Ningxia Medical UniversityAbstract Purpose This study aims to identify the risk factors for the progression from pulmonary tuberculosis (PTB) to spinal tuberculosis (STB), which is crucial for early disease intervention, optimizing treatment strategies, and improving patient prognosis. Methods A retrospective analysis was conducted on 326 patients diagnosed with PTB between January 2017 and October 2024. Demographic, clinical, and socioeconomic data were collected, including age, gender, body mass index (BMI), Karnofsky Performance Status (KPS), Nutritional Risk Screening 2002 (NRS-2002) score, diabetes, per capita income, smoking status, alcohol consumption, and a history of recurrent PTB. Univariate and multivariate logistic regression analyses were performed to identify significant risk factors for the progression to STB, and interaction effect analysis and risk stratification based on the NRS-2002 score were conducted to assess its predictive value. Results Univariate logistic regression revealed that the NRS-2002 score (OR = 2.762, p < 0.001), recurrent PTB (OR = 15.370, p < 0.001), and living in relative poverty (OR = 10.000, p = 0.002) were significant risk factors for the progression from PTB to STB. Multivariate logistic regression confirmed that the NRS-2002 score (OR = 11.22, p < 0.001), recurrent PTB (OR = 5.08, p < 0.001), and living in relative poverty (OR = 2.58, p < 0.001) were independently associated with increased likelihood of STB progression. Stratified analysis revealed a clear dose-response relationship between higher NRS-2002 scores and the risk of progression to STB, with those having scores ≥ 6 exhibiting the highest odds (OR = 91.59, p < 0.001). Conclusions This study highlights critical risk factors for the progression from PTB to STB, particularly the NRS-2002 score, recurrent PTB, and socioeconomic status (living in relative poverty). The NRS-2002 score was identified as the most significant predictor, demonstrating a strong dose-response relationship with disease progression. Clinically, early identification of patients with elevated NRS-2002 scores, alongside timely nutritional interventions and efforts to alleviate poverty, can significantly reduce the risk of STB development. These findings can inform clinical decision-making, enhance early intervention strategies, and guide public health policies aimed at preventing STB, particularly in high-risk populations.https://doi.org/10.1186/s13018-025-05848-3Pulmonary tuberculosisSpinal tuberculosisLogistic regressionRecurrent pulmonary tuberculosisRisk stratification
spellingShingle Di Xue
Xiaolei Chen
Lufei Shao
Qinfu Liu
Jia Chen
Yajing Su
Chen Zhang
Zhirong Chen
Min Su
Zhiqiang Wu
Yiqiang Yang
Xue Lin
Risk factors for the progression from pulmonary tuberculosis to spinal tuberculosis: a logistic regression analysis
Journal of Orthopaedic Surgery and Research
Pulmonary tuberculosis
Spinal tuberculosis
Logistic regression
Recurrent pulmonary tuberculosis
Risk stratification
title Risk factors for the progression from pulmonary tuberculosis to spinal tuberculosis: a logistic regression analysis
title_full Risk factors for the progression from pulmonary tuberculosis to spinal tuberculosis: a logistic regression analysis
title_fullStr Risk factors for the progression from pulmonary tuberculosis to spinal tuberculosis: a logistic regression analysis
title_full_unstemmed Risk factors for the progression from pulmonary tuberculosis to spinal tuberculosis: a logistic regression analysis
title_short Risk factors for the progression from pulmonary tuberculosis to spinal tuberculosis: a logistic regression analysis
title_sort risk factors for the progression from pulmonary tuberculosis to spinal tuberculosis a logistic regression analysis
topic Pulmonary tuberculosis
Spinal tuberculosis
Logistic regression
Recurrent pulmonary tuberculosis
Risk stratification
url https://doi.org/10.1186/s13018-025-05848-3
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