Clinical predictors of tracheobronchial tuberculosis and airway stenosis in pulmonary tuberculosis

Among 1,999 patients with pulmonary tuberculosis who underwent bronchoscopy at West China Hospital in southwestern China, 439 were diagnosed with tracheobronchial tuberculosis, and 218 of those affected patients—49.7%—also developed airway stenosis. The single-centre retrospective study reports that female sex, age below 50 years and a positive sputum acid-fast smear were independently associated with tracheobronchial tuberculosis in this selected clinical population.

The researchers reviewed patients treated at West China Hospital between September 2013 and June 2019. Patients were eligible if they had confirmed pulmonary tuberculosis, underwent bronchoscopy and had complete baseline clinical data available. Of the 1,999 included patients, 439, or 22.0%, were assigned to the tracheobronchial tuberculosis case group, while 1,560, or 78.0%, had no bronchoscopic evidence of the condition. The analysis evaluated both the presence of tracheobronchial tuberculosis and the occurrence of associated tracheobronchial stenosis.

Multivariable logistic regression identified three independent predictors of tracheobronchial tuberculosis. Female sex carried an odds ratio of 5.726, with a 95% confidence interval of 1.913 to 17.133 and a p-value of 0.002. Patients younger than 50 years had an odds ratio of 4.144, with a 95% confidence interval of 1.791 to 9.588 and a p-value of 0.001. A positive sputum acid-fast smear was associated with an odds ratio of 2.494, with a 95% confidence interval of 0.998 to 6.636 and a p-value of 0.050. These estimates describe associations within the retrospective analysis, rather than proving that the characteristics caused the disease. The confidence interval for the smear result also included values close to 1, reflecting greater uncertainty around that estimate.

Airway stenosis was common among the 439 patients identified with tracheobronchial tuberculosis: 218, or 49.7%, developed tracheobronchial stenosis. The supplied results do not report the corresponding number among patients with pulmonary tuberculosis who did not have tracheobronchial involvement, so they do not establish a risk contrast between the groups. The abstract also does not specify the timing of stenosis development or the clinical outcomes associated with it. Although the findings describe demographic and laboratory characteristics associated with bronchoscopic identification of tracheobronchial disease, the retrospective design and the requirement for bronchoscopy limit direct extrapolation to people with pulmonary tuberculosis who were not referred for the procedure.

The 22.0% proportion should not be interpreted as the prevalence of tracheobronchial tuberculosis among all patients with pulmonary tuberculosis. Every participant in the analysed cohort had undergone bronchoscopy, making the sample different from an unselected pulmonary tuberculosis population. The wide confidence intervals for several predictors, particularly female sex and age below 50 years, also indicate substantial uncertainty in the estimated effect sizes. The results instead provide a clinical profile observed in a hospital cohort: young to middle-aged women with pulmonary tuberculosis and positive sputum acid-fast smears were more likely to receive a bronchoscopic diagnosis of tracheobronchial tuberculosis than the comparison patients.

Subject of Research: Clinical predictors of tracheobronchial tuberculosis and associated airway stenosis in patients with pulmonary tuberculosis

Article Title: Clinical predictors of tracheobronchial tuberculosis and associated airway stenosis among patients with pulmonary tuberculosis: a study from Southwestern China

Article References: Ding, X.-J., Yu, M., Ji, G.-Y., & He, J.-Q. (2026). Clinical predictors of tracheobronchial tuberculosis and associated airway stenosis among patients with pulmonary tuberculosis: a study from Southwestern China. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14262-x

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14262-x

Keywords: tracheobronchial tuberculosis, airway stenosis, pulmonary tuberculosis, bronchoscopy, acid-fast smear, clinical predictors, retrospective study, southwestern China, Clinical, predictors, tracheobronchial, tuberculosis