Effect of age, gender, and linezolid use on MDR-TB Patient survival rate with short-course treatment in Central Java, Indonesia: survival analysis and cox regression 10.55131/jphd/2025/230304

Abstract

MDR-TB treatment regimens of 9 -12 months provide effectiveness and shorter duration of therapy. However, it was found that 9.22% of patients died during short-term treatment for MDR-TB from 2021-2023 in Central Java, Indonesia. This study aims to analyze the probability of survival and risk factors for mortality in patients undergoing short-term treatment for MDR-TB. A retrospective cohort study involving 236 MDR-TB patients who received a short-term regimen during 2022-2023 and had either a cure or death outcome. Kaplan-Meier analysis was used to describe incidence rates and median time to death. Cox-Proportional Hazard model was used to identify predictors such as age category, gender, employment status, treatment history, DM status, HIV, Linezolid use, and treatment initiation. Statistical analysis was performed using Rstudio with significance <0.005. Kaplan-Meier results showed a significant difference in survival probability across the three age groups. The young age group (19-35 years) had a higher survival probability than the middle age (36-55 years), and old age (≥56 years) (Chi-Square = 17, p < 0.001). Cox regression results showed that patients aged ≥56 years had a 3.705 times higher risk of death than younger patients (CI95% = 1.4896-3.646, HR = 3.705, p = 0.001). The results of this study emphasize the importance of special interventions for older patients (≥56 years) in the form of intensive monitoring and management of comorbidities of DM and HIV to reduce the risk of higher mortality. These findings support an age-based approach to MDR-TB therapy as an optimal measure to improve patient survival