Union of Foot/Ankle Arthrodesis: A Registry Study of Low-Intensity Pulsed Ultrasound (LIPUS)

Category: Ankle; Hindfoot; Midfoot/Forefoot; Trauma. Introduction/Purpose: To aid in healing and avoid costly revision surgery, bone grafts, growth factors, and bone stimulation devices are used as adjuncts to foot/ankle arthrodesis. This study evaluated the union rates of LIPUS as an adjunct to foot/ankle arthrodesis and the corresponding factors associated with improved healing. Methods: Foot/ankle arthrodesis patients were identified retrospectively from a prospective post-market arthrodesis/fracture registry for EXOGEN (Bioventus LLC, Durham, NC). Inclusion criteria were males or non-pregnant females 18 years of age or older at time of enrollment, known date of fracture, known start and end dates of LIPUS treatment, and known treatment success outcome. Treatment success was defined by both clinical (solid and pain-free on manual stress) and radiological (at least 3 of 4 cortices bridged on x-rays) criteria. Association between union rates and surgical treatments, comorbidities, and medications was tested with Chi-square tests. Results: A total of 235 primary and 16 revision foot/ankle arthrodesis patients used EXOGEN. 41.4% used EXOGEN within 90 days of the fracture/arthrodesis. Overall union rate was 86.9% (primary: 86.4%; revision: 93.8%). Having the comorbidity of diabetes, obesity, or current smoker was not associated with a higher non-union rate (p=0.779). Other comorbidities were also not associated with increased non-union rates (e.g., Charcot disease p=0.614, NSAID p=0.862, steroids p=0.647). EXOGEN use within 90 days of the fracture/procedure date was associated with improved union rates for the overall (p=0.004, odds ratio (OR) 3.7 (95% CI: 1.5-9.3)) and primary (p=0.007, OR 3.4 (95% CI: 1.3-8.6)) groups. For the overall group, union rates were 94.2% (EXOGEN use <=90 days post-fracture/procedure), 80.6% (91 to 365 days), and 84.6% (>365 days). Conclusion: Union rates for foot/ankle arthrodesis with adjunctive LIPUS were comparable to other therapies with and without other adjuncts (Table 1). Known risk factors for non-union, such as smoking and Charcot disease, were not found to be associated with healing for the LIPUS patients. This suggests the possibility that LIPUS was able to mitigate potential patient risk factors and may offer a low risk post-operative adjunct in difficult healing scenarios. [Table: see text]

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Union of foot/ankle Arthrodesis: A Registry Study of Low-intensity Pulsed Ultrasound (LIPUS)

10.21203/rs.3.rs-150269/v1 ◽

2021 ◽

Author(s):

Neil White ◽

Johnny Lau ◽

Kevin Ong ◽

Steven Kurtz ◽

Sheldon Lin

Keyword(s):

Risk Factors ◽

Treatment Success ◽

Ankle Arthrodesis ◽

Current Smoker ◽

Primary Group ◽

Union Rate ◽

Pulsed Ultrasound ◽

Non Union ◽

Low Intensity Pulsed Ultrasound ◽

Low Intensity

Abstract Background: Bone grafts and bone stimulation devices are used as adjuncts to foot/ankle arthrodesis to improve healing and reduce revision risk. Union rates of low-intensity pulsed ultrasound (LIPUS) and the factors associated with improved healing were evaluated. Methods: From a prospective arthrodesis/fracture registry for EXOGEN (Bioventus LLC), treatment success for foot/ankle arthrodesis patients were was evaluated, based on both clinical (solid and pain-free on manual stress) and radiological (3 of 4 cortices bridging) criteria. Associations between union rates and surgical treatments, comorbidities, and medications were tested.Results: EXOGEN was used by a total of 235 primary and 16 revision foot/ankle arthrodesis patients. Of these, 41.4% used EXOGEN within 90 days of the fracture/arthrodesis. EXOGEN use within 90 days of the fracture/arthrodesis was associated with improved union rates (overall group (p=0.004, odds ratio (OR) 3.675 (95% CI: 1.459-9.258)); primary group (p=0.007, OR 3.383 (95% CI: 1.335-8.574))). The overall union rate was 86.9% (primary: 86.4%; revision: 93.8%). Patients with the comorbidity of diabetes, obesity, or current smoker were not associated with a higher non-union rate (p=0.779). Other comorbidities were not associated with increased non-union rates (Charcot disease p=0.614, NSAID p=0.862, steroids p=0.647). For all patients, union rates were 94.2% (EXOGEN use ≤90 days post-fracture/arthrodesis) and 81.6% (>90 days). Conclusions: Union rates for foot/ankle arthrodesis with adjunctive LIPUS were comparable to other therapies. Known patient risk factors for non-union were not found to be associated with impaired healing for the LIPUS patients, suggesting the possibility that LIPUS may mitigate these known risk factors.

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Efficacy of a Cellular Bone Allograft for Foot and Ankle Arthrodesis and Revision Nonunion Procedures

Foot & Ankle International ◽

10.1177/1071100716674977 ◽

2016 ◽

Vol 38 (3) ◽

pp. 277-282 ◽

Cited By ~ 11

Author(s):

Travis J. Dekker ◽

Peter White ◽

Samuel B. Adams

Keyword(s):

Risk Factors ◽

High Risk ◽

Bone Allograft ◽

Ankle Arthrodesis ◽

Foot And Ankle ◽

Union Rate ◽

Joint Preparation ◽

History Of ◽

Cellular Bone ◽

Cellular Bone Allograft

Background: Bone graft substitutes are often required in patients at risk for nonunion, and therefore, an allograft that most closely mimics an autograft is highly sought after. This study explored the utility and efficacy of a cellular bone allograft used for foot and ankle arthrodesis and revision nonunion procedures in a patient population at risk for nonunion. Methods: An institutional review board–approved retrospective review of consecutive patients who underwent arthrodesis and revision nonunion procedures with a cellular bone allograft was performed at a single academic institution. No external sources of funding were provided for this study. Inclusion criteria included patients who were more than 1 year after surgery or less than 1 year after surgery if they had undergone a second operative procedure for nonunion or if they had computed tomography–documented union. Forty operative procedures in 36 patients with a mean follow-up of 13 months (range, 6-25 months) were included for data analysis. All patients had at least one of the following risk factors associated with nonunion: current smoker, diabetes, avascular necrosis (AVN) of the involved bone, active same-site operative infection, history of nonunion, previous same-site surgery, or gap of 5 mm or greater after joint preparation. The primary outcome was radiographic union. Results: The union rate in this high-risk population was 83% (33/40). Univariate analysis demonstrated that the use of a cellular bone allograft helped mitigate the presence of risk factors known to cause nonunion. There was no significant difference in fusion rates among groups with current smoking, AVN of the involved bone, active same-site operative infections, history of nonunion, rheumatoid arthritis on medication, previous same-site operative procedures or infections, or a gap of 5 mm or greater after joint preparation. However, in this population, diabetic and female patients remained at a high risk of recurrent nonunion ( P = .0015), despite the use of a cellular bone allograft. Chi-square analysis of patients with increasing numbers of risk factors directly correlated with an increased risk of nonunion ( P = .025). Four wound complications were reported in this cohort that required irrigation and debridement (10%). Conclusion: These data demonstrated a union rate of 83% in patients with risk factors known to cause nonunion. The benefits of the use of a cellular bone allograft allowed for the avoidance of morbidity associated with autograft harvesting while still improving the local biology to facilitate fusion in a difficult patient population to attain a successful fusion mass. Level of Evidence: Level IV, retrospective case series.

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Early Outcomes on the Use of an Anterior Plate for complicated Ankle Fusions

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00195 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0019

Author(s):

J. Chris Coetzee ◽

Rebecca Stone

Keyword(s):

Plate Fixation ◽

Ankle Arthrodesis ◽

Senior Author ◽

Wound Complications ◽

X Rays ◽

Anterior Plate ◽

Non Union ◽

Ankle Fusion ◽

Major Complications

Category: Ankle Introduction/Purpose: An ankle fusion is indicated for severe osteoarthritis of the ankle. An anterior ankle fusion plate for tibiotalar fusions provides a rigid and reproducible solution to treat ankle arthritis. With a plate fixation it might be possible to treat more complex deformities and provide additional stability in compromised patients. This study documents the early outcomes on the use of an anterior plate for patients undergoing an ankle arthrodesis. Methods: All ankle fusions using the anterior plate at our center were included and followed. Fifty-one patients (53 ankles) presented to the senior author between September 2014 and February 2017. Patients experienced ongoing ankle pain due to degenerative changes, a previous ankle fusion, post-traumatic arthritis (PTA) or failure of a total ankle arthroplasty (TAA). All patients’ medical and ankle surgical history was documented. This study was conducted in compliance and approved with a local IRB. Outcomes were evaluated pre-operatively and post-operatively with the Veterans Rand Health Survey (VR-12), Ankle Osteoarthritis Scale (AOS) and Visual Analog Scale (VAS) Pain scale. A patient satisfaction survey was distributed to all patients and results were tabulated. Average follow up for outcome scores 16.8 months (range 6 – 38 months). Results: Fifty-one patients(29 females) with the mean age of 56.56 years(26.3–74.8) had a mean follow-up of 16.6months(6– 38months). Diagnoses included 17 primary, 10 revision, 6 TAA failures and 20 PTA. 86.3%(44 patients) were non-diabetic. Non-smokers included 43.1%(22). VR-12 Physical improved from 29.46 to 37.72, and Mental 47.34 to 52.55 pre-operatively to post-operatively, respectively. AOS Pain improved: 462.41 to 252.8; AOS Disability: 567.52 to latest 387.77. Mean VAS improved from pre-operatively of 54.28 to latest of 30.61. Arthrodesis rate was 98%(52/53 ankles). 45 ankles were fused at 3 months by x-rays. Symptomatic patients (with pain) had a CT scan done at a minimum of 3 months (1/8 CT scans showed non-union & 7 were fused). Major complications were 3.8%(2 patients). There were no wound complications. Conclusion: An anterior plate construct is more invasive compared to arthroscopic or other arthrodesis options. However, the stability of the construct allows for a reliable option in complex situations, and the arthrodesis rate appears to be exceptional. In this complex patient population, the arthrodesis rate was 98%, while major complications only 4%. Summary Sentence: Anterior plate construct is more invasive compared to arthroscopic/other arthrodesis options. However, stability of the construct allows for a reliable option and fusion rates seem to be exceptional.

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Impact of Hardware Choice on Talonavicular Arthrodesis Non-Union Rate

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00174 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0017

Author(s):

Daniel Corr ◽

Parth Kothari ◽

David I. Pedowitz

Keyword(s):

Risk Factors ◽

Talonavicular Joint ◽

Union Rate ◽

Fixation Technique ◽

Triple Arthrodesis ◽

Non Union ◽

Patient Demographics ◽

Single Screw ◽

Hardware Complications ◽

Removal Of Hardware

Category: Midfoot/Forefoot; Ankle Arthritis; Hindfoot Introduction/Purpose: Talonavicular arthrodesis is a commonly performed procedure in orthopedic foot and ankle surgery, for conditions including osteoarthritis, instability, and others. The surgery is frequently performed as part of a double or triple arthrodesis. Multiple surgical constructs have been described, including screws, plate/screw constructs, and staple/screw constructs. Few studies exist that specifically focus on the talonavicular joint, and those that do are often limited by low patient volumes. Studies that do study non-union of the talonavicular joint do not offer comparative data on non-union rates between the different methods of fixation. The purpose of this study was to determine the rate of arthrodesis in talonavicular fusion surgery among different fixation techniques and determine if hardware has a significant effect on union rate. Methods: This study is a retrospective single institution, multi-surgeon study evaluating arthrodesis rates in the talonavicular joint. Adult patients undergoing primary talonavicular fusion (isolated or as part of double/triple arthrodesis) from 2015-2018 with a minimum of 3 month radiographic follow-up were studied. Patients undergoing revision talonavicular fusion or fusion as part of Charcot reconstruction were excluded. Patient radiographic and chart notes were reviewed to assess fixation type (single screw, 2-hole compression plate, screw + staple, or 4-hole plate), the status of the arthrodesis at >=3 months and any hardware complications or reoperations following the index procedure. Descriptive statistics were generated for standard patient demographics and co-morbidities. Non-union rates were calculated for the cohort as a whole and for each fixation technique utilized along with the frequency of hardware complications/removal. Univariate analysis was performed to determine risk factors for increased non-union rate, including patient demographics, co-morbidities, and fixation technique. Results: A total of 101 patients were included. Hardware included 69 single screws, 27 two-hole compression plates, and 4 screw + staple constructs. Four patients (3.96%) went on to develop a nonunion of the talonavicular joint, while 10 patients (9.9%) required a removal of hardware procedure following the initial arthrodesis. Of nonunion cases, 3 patients had single screw hardware while 1 had a two-hole plate. Removal of hardware was necessary in 5/69 patients with single screws (7.2%) and 4/27 patients with 2-hole plates (14.8%). Statistical significance could not be concluded when comparing union vs. nonunion patients due to the success of union across hardware groups that resulted in a scarce nonunion patient population (4 patients). Conclusion: This study demonstrates that there are multiple types of hardware appropriate for achieving and maintaining talonavicular fusion. One limitation of this report is that the majority of non-single screw cases utilized a 2-hole plate, with significantly fewer patients utilizing screw + staple and 4-hole plate constructs. Single screw and 2-hole plate hardware techniques achieve excellent rate of union, and physicians can make decisions of which to utilize based on patient factors. Further study is indcated on even larger patient cohorts with increased population of nonunion cases so that significant patient risk factors for nonunion of the joint can be identified. [Table: see text]

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Risk factors for delayed and non-union following transfibular ankle arthrodesis

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20210526 ◽

2021 ◽

Vol 7 (2) ◽

pp. 199

Author(s):

Hyeon Soo Kim ◽

Sung Jin Shin ◽

Jin Woo Kim

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Ankle Joint ◽

Significant Risk ◽

Significant Risk Factor ◽

Ankle Arthrodesis ◽

Delayed Union ◽

Non Union ◽

Group A ◽

Group B

Background: This study was to identify risk factors associated with delayed union and non-union in patients who underwent transfibular ankle arthrodesis.Methods: This study included 43 patients who underwent ankle arthrodesis using transfibular approach between January 2012 and September 2018 and were followed up for more than 12 months. The patients were divided into two groups according to delayed union or non-union. Group A included patients who had delayed union or non-union and Group B included patients without these complications. Variables that could contribute to non-union including etiologies, age, chronic renal failure, hypertension, diabetes, smoking, pre-operative talus bone quality, pre-operative angulation of the talus and fixation methods were evaluated.Results: The mean time to bone union was 12.7±7.25 weeks. Group A included 12 patients with 5 cases of non-union and 7 cases of delayed union and group B included 31 patients. Infection of the ankle joint (OR, 1.73; p=0.041) was risk factor for non-union and delayed union on the basis of multivariate analysis.Conclusions: We concluded that infection of the ankle joint is the most significant risk factor for delayed union and nonunion in our study. Careful attention should be paid preoperatively, intraoperatively and postoperatively to patients who have this risk factor to obtain a satisfactory surgical outcome.

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Outcomes of Exogen low-intensity pulsed ultrasound in the management of delayed union following elective foot and ankle surgery

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00420 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0042

Author(s):

Ashley Scrimshire ◽

Paulo Torres ◽

Michal Koziara ◽

Jack Allport

Keyword(s):

Smoking Status ◽

Corrective Osteotomy ◽

Delayed Union ◽

Foot And Ankle ◽

Union Rate ◽

Pulsed Ultrasound ◽

Non Union ◽

Low Intensity Pulsed Ultrasound ◽

Low Intensity ◽

Ankle Surgery

Category: Basic Sciences/Biologics Introduction/Purpose: Exogen low-intensity pulsed ultrasound therapy is well established in the management of fracture delayed or non-union. Its use in trauma has recently been recommended by the National Institute for Clinical Excellence in England. In comparison the use of Exogen for managing delayed union following elective foot and ankle surgery has not previously been reported in the literature. We aim to review the indications for and outcomes following Exogen therapy for managing delayed union following elective foot and ankle surgery in our English tertiary referral centre. Methods: Case notes and imaging were reviewed for all patients receiving Exogen therapy following elective foot and ankle surgery from July 2012 - July 2017 in our centre. Data were collected on patient demographics, smoking status, comorbidities, indications for and type of surgery performed, duration of Exogen therapy and final outcomes. Union was confirmed radiologically and clinically. Results: 58 patients were included, 18 smokers and 8 diabetic. The mean age was 55 years. 50 underwent an arthrodesis, 8 an osteotomy. Exogen was started a mean of 244-days post-operatively. 24 patients went on to complete union; a further 7 were showing good progress towards union. When grouped together the union rate was 53.4% (n=31). Complete union took a mean of 177-days (range 44–441). The non-union rate was 46.6% (n=27) despite a mean of 330-days treatment (range 72–1112). 1 was complicated by infection. There were no significant differences in age, time to commencing Exogen, number of smokers or diabetics between the groups. The non-union group had significantly longer treatment (p=0.003). Union was more likely following an osteotomy (n=6/8,75%) or surgery to the hindfoot (n=6/7,86%). Conclusion: We have found Exogen can be beneficial in managing delayed union following elective foot and ankle surgery for over half of patients. This can potentially reduce the number of revision surgeries required. We found no correlation between patient age, smoking or diabetes in outcome. Union was more likely following a corrective osteotomy or surgery to the hindfoot. This data can help inform clinicians in their decision-making and in counselling patients.

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Venous Thromboembolism and High Grade Gliomas

Thrombosis and Haemostasis ◽

10.1055/s-0038-1649592 ◽

1993 ◽

Vol 70 (03) ◽

pp. 393-396 ◽

Cited By ~ 38

Author(s):

Mandeep S Dhami ◽

Robert D Bona ◽

John A Calogero ◽

Richard M Hellman

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Medical Center ◽

Significant Risk ◽

Bleeding Complications ◽

Fisher Exact Test ◽

High Grade ◽

Chi Square ◽

Exact Test ◽

High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

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PENGARUH PEMBERIAN PELAYANAN INFORMASI OBAT DAN KONSELING TERHADAP TINGKAT KEPATUHAN MINUM OBAT PADA PASIEN DIABETES MELITUS DENGAN HIPERTENSI DI RUMAH SAKIT DAERAH IDAMAN BANJARBARU

Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan ◽

10.36387/jiis.v5i2.462 ◽

2020 ◽

Vol 5 (2) ◽

pp. 240-249

Author(s):

Satrio Wibowo Rahmatullah ◽

◽

Ika Maulida Nurrahma ◽

Adnan Syahrizal

Keyword(s):

Drug Information ◽

Treatment Success ◽

Information Service ◽

Regional Hospital ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Quasi Experimental ◽

High Level ◽

Chi Square Analysis

Compliance to achieve treatment success can be improved by providing drug information services (PIO) and counseling to improve understanding of treatment instructions. The general objective of this study was to determine the effect of drug information service and counseling on the level of medication adherence in patients with diabetes mellitus (DM) with hypertension in the Banjarbaru Regional Hospital. This study uses a quasi experimental method with a cross sectional approach and takes patient data prospectively. The results of this study indicate that the group given PIO and counseling showed a high level of adherence as many as 20 respondents (100%). Whereas in the group that was not given PIO and the counseling level of adherence was low, there were 4 respondents (20%). Based on the mann-whitney analysis p-value = 0,000 (<α = 0.05) so that there are differences in the group with PIO and counseling with groups without PIO and counseling, while the chi square analysis p-value = 0.004 (<α = 0 , 05) so that PIO and counseling have a significant effect on the level of adherence to taking medication in patients with DM with hypertension at the Banjarbaru Regional Hospital.

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Characteristics and risk factors associated with stroke subtypes among adult patients admitted to stroke unit of JUMC

Current Hypertension Reviews ◽

10.2174/1573402115666191121120228 ◽

2019 ◽

Vol 15 ◽

Author(s):

Bekalu Getachew Gebreegziabher ◽

Tesema Etefa Birhanu ◽

Diriba Dereje Olana ◽

Behailu Terefe Tesfaye

Keyword(s):

Risk Factors ◽

Stroke Unit ◽

Medical Center ◽

Data Entry ◽

Public Health Problem ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Factors Associated ◽

Stroke Subtypes

Background: Stroke is a great public health problem in Ethiopia. According to reports, in-hospital stroke mortality was estimated to be 14.7% in Ethiopia. Despite this, in this country researches done on factors associated with stroke sub-types were inadequate. Objective: To assess the Characteristics and risk factors associated with stroke sub-types among patients admitted to JUMC. Methods and materials: A retrospective cross sectional study was conducted from May 2017 to May 2018 in stroke unit of Jimma University Medical Center. A total of 106 medical charts of patients diagnosed with stroke were reviewed. Checklist comprising of relevant variables was used to collect data. SPSS version 21 was employed for data entry and analysis. Chi-square test was used to point-out association and difference among stroke sub-types. The data was presented using text, tables and figures. Result: From a total of 106 patients, 67(63.2%) were men. The mean ± SD of age was 52.67±12.46 years, and no significant association was found. Of all the patients, 59(55.6%) had ischemic strokes and 47(44.4%) had hemorrhagic strokes. The most common risk factor in the patients was alcohol use with a prevalence of 69.9%. Of all the risk factors, only sex, cigarettes smoking and dyslipidemia were significantly associated to sub-types of stroke. Conclusion: Ischemic stroke was the most common subtype of stroke. Sex of patient, cigarette smoking and dyslipidemia are significantly associated with the two stroke subtypes.

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Trends, Characteristics and Treatment Outcomes of Patients with Drug-Resistant Tuberculosis in Uzbekistan: 2013–2018

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094663 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4663

Author(s):

Khasan Safaev ◽

Nargiza Parpieva ◽

Irina Liverko ◽

Sharofiddin Yuldashev ◽

Kostyantyn Dumchev ◽

...

Keyword(s):

Risk Factors ◽

Treatment Outcomes ◽

Treatment Success ◽

National Level ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Loss To Follow Up ◽

Resistant Tuberculosis ◽

Mdr Tb

Uzbekistan has a high burden of drug-resistant tuberculosis (TB). Although conventional treatment for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) has been available since 2013, there has been no systematic documentation about its use and effectiveness. We therefore documented at national level the trends, characteristics, and outcomes of patients with drug-resistant TB enrolled for treatment from 2013–2018 and assessed risk factors for unfavorable treatment outcomes (death, failure, loss to follow-up, treatment continuation, change to XDR-TB regimen) in patients treated in Tashkent city from 2016–2017. This was a cohort study using secondary aggregate and individual patient data. Between 2013 and 2018, MDR-TB numbers were stable between 2347 and 2653 per annum, while XDR-TB numbers increased from 33 to 433 per annum. At national level, treatment success (cured and treatment completed) for MDR-TB decreased annually from 63% to 57%, while treatment success for XDR-TB increased annually from 24% to 57%. On multivariable analysis, risk factors for unfavorable outcomes, death, and loss to follow-up in drug-resistant TB patients treated in Tashkent city included XDR-TB, male sex, increasing age, previous TB treatment, alcohol abuse, and associated comorbidities (cardiovascular and liver disease, diabetes, and HIV/AIDS). Reasons for these findings and programmatic implications are discussed.

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