A predictive model for early clinical diagnosis of spinal tuberculosis based on conventional laboratory indices: A multicenter real-world study

Abstract

BackgroundEarly diagnosis of spinal tuberculosis (STB) remains challenging. The aim of this study was to develop a predictive model for the early diagnosis of STB based on conventional laboratory indicators.MethodThe clinical data of patients with suspected STB in four hospitals were included, and variables were screened by Lasso regression. Eighty-five percent of the cases in the dataset were randomly selected as the training set, and the other 15% were selected as the validation set. The diagnostic prediction model was established by logistic regression in the training set, and the nomogram was drawn. The diagnostic performance of the model was verified in the validation set.ResultA total of 206 patients were included in the study, including 105 patients with STB and 101 patients with NSTB. Twelve variables were screened by Lasso regression and modeled by logistic regression, and seven variables (TB.antibody, IGRAs, RBC, Mono%, RDW, AST, BUN) were finally included in the model. AUC of 0.9468 and 0.9188 in the training and validation cohort, respectively.ConclusionIn this study, we developed a prediction model for the early diagnosis of STB which consisted of seven routine laboratory indicators.

Combined clinical significance of MRI and serum mannose-binding lectin in the prediction of spinal tuberculosis

“…Its onset and the atypical symptoms at the early stage can easy to be confused with septic spondylitis, osteoporotic vertebral compression fracture, various kinds of spinal primary tumors or metastatic tumors, eosinophilic granuloma and other diseases. This confusion can lead to diagnostic errors, increasing the pain of the patients and delaying the treatment [ 4 , 5 ]. Moreover, if the disease worsens, it may result in nerve function damage, and spinal deformity, leading to muscle weakness, sensory loss, spinal scoliosis, scoliosis, and even limb paralysis [ 6 , 7 ].…”

“…However, the lengthy process and low positivity rate of bacterial culture make it unsuitable for early diagnosis and treatment. In addition, distinguishing Mycobacterium tuberculosis from other bacterial granulomatous lesions on pathologic examination can be challenging, increasing the difficulty of diagnosis [ 4 ]. Currently, STB is mainly diagnosed by a combination of clinical manifestations, laboratory tests, imaging tests, and pathologic biopsies [ 9 ].…”