Factores de riesgo que influyen en el fracaso al tratamiento individualizado de tuberculosis multidrogorresistente en la provincia de Ica. 2000-2014 / Risk factors that influence in the failure to the individualized treatment of multidrug-resistant tuberculosis in the province of ica. 2000-2014

RESUMEN

Objetivo: Determinar los factores de riesgo que influyen en el fracaso al tratamiento individualizado de Tuberculosis Multidrogorresistente en la provincia de Ica. 2000-2014. Materiales y métodos: Estudio observacional, retrospectivo, tipo analítico, de casos y controles. La muestra estuvo conformada por 19 casos de fracaso al tratamiento individualizado, y por cada caso se tuvo dos controles de pacientes que curaron con tratamiento individualizado. Se realizó el análisis bivariado con un nivel de significancia del 5% se calculó del Odds Ratio (OR) con intervalo de confianza (IC) al 95%. Se realizó análisis de regresión logística. Resultados: En el análisis multivariado resultaron 4 factores de riesgo asociados a fracaso al tratamiento individualizado: resistencia a 5 o más drogas (OR=6,67, p=0,027), tener IMC menor de 18.5 al inicio del tratamiento (OR=7,61 p=0,023), presentar hemoptisis durante el tratamiento (OR= 19,89, P=0,001) y la presencia de cavernas en la radiografía de tórax inicial (OR=27,95, p=0,005). Conclusiones: Los pacientes con resistencia a 5 o más drogas antituberculosas, con IMC menor a 18.5, con hemoptisis durante el tratamiento y los que presentan caverna en la radiografía de tórax, tienen mayor riesgo de fracasar al tratamiento individualizado. (AU)

ABSTRACT

Objective: To determine the risk factors that influence the failure to individualized treatment of multidrug-resistant tuberculosis in the province of Ica. 2000-2014. Materials and methods:Observational, retrospective study, analytical type, of cases and controls. The sample consisted of 19 cases of failure to individualized treatment, and for each case there were two controls of patients who cured with individualized treatment. The bivariate analysis was performed with a level of significance of 5% was calculated from the Odds Ratio (OR) with 95% confidence interval (CI). Logistic regression analysis was performed. Results: In the multivariate analysis, there were 4 risk factors associated with failure to individualized treatment: resistance to 5 or more drugs (OR = 6.67, p = 0.027), having a BMI less than 18.5 at the beginning of treatment (OR = 7, 61 p = 0.023), presenting hemoptysis during treatment (OR = 19.89, P = 0.001) and the presence of caverns on the initial chest radiograph (OR = 27.95, p = 0.005). Conclusions: Patients with resistance to 5 or more antituberculous drugs, with a BMI less than 18.5, with hemoptysis during treatment and those who have a cavern on chest radiography, have a higher risk of failing individualized treatment. (AU)