Abstract：Objective To analyze the recurrence and influencing factors of pulmonary tuberculosis among patients with initial treatment success, so as to provide evidence for preventing pulmonary tuberculosis recurrence. Methods Patients with initial treatment success for pulmonary tuberculosis confirmed in Taizhou City, Zhejiang Province from 2010 to 2024 were selected as study subjects. Data including basic information, comorbidities and etiological results were collected through the Tuberculosis Management Information System of China Disease Prevention and Control Information System. A retrospective cohort study was conducted. The end date of initial treatment success was set as the starting point of observation, and 2025 was set as the end point of observation. Pulmonary tuberculosis recurrence (re-diagnosis of pulmonary tuberculosis ≥6 months after the completion of initial treatment success) was set as the outcome event. A multivariable Cox proportional hazards regression model was used to analyze the influencing factors for recurrence of pulmonary tuberculosis among patients with initial treatment success. Results A total of 37 236 patients with initial treatment success for pulmonary tuberculosis were enrolled, including 25 879 males (69.50%) and 11 357 females (30.50%). The mean age of patients was (46.09±19.34) years. The median follow-up duration was 7.85 (interquartile range, 7.75) years. A total of 873 recurrence cases were identified, with a recurrence rate of 2.34%. Multivariable Cox proportional hazards regression analysis showed that male patients had a 32.2% (HR=1.322, 95%CI: 1.129-1.548) higher recurrence risk than female patients. Each one-year increase in age was associated with a 1.6% (HR=1.016, 95%CI: 1.012-1.020) higher recurrence risk. Compared with farmers, workers and students had 27.5% (HR=0.725, 95%CI: 0.587-0.895) and 51.0% (HR=0.490, 95%CI: 0.265-0.908) lower recurrence risk, respectively. Patients with positive etiology had a 60.1% (HR=1.601, 95%CI: 1.396-1.835) higher recurrence risk than those with negative or missing etiology. Conclusion Gender, age, occupation and etiological results were possibly associated with recurrence of pulmonary tuberculosis among patients with initial treatment success.
