Objective To understand the treatment outcomes and influencing factors in pulmonary tuberculosis (TB) patients in the elderly in Gansu province and provide evidence to increase the successful treatment rate of pulmonary TB in the elderly.

Methods The information about pulmonary tuberculosis patients aged ≥60 registered in Gansu from 2018 to 2022 were collected from National Tuberculosis Information Management System, and logistic regression analysis was used to identify the influencing factors for the treatment outcomes of pulmonary TB in the elderly.

Results A total of 13170 pulmonary TB patients aged ≥60 years were registered in Gansu from 2018 to 2022, in whom 12219 were successfully treated, the successful treatment rate showed an increasing trend (trend χ²=5.979, P=0.014 ). Multivariate logistic regression analysis showed that being man odds ratio (OR)=1.59, 95% confidence interval (CI): 1.39–1.83, middle-age (70− years old ) (OR=1.73, 95%CI: 1.49–2.01), old age (≥80 years old) (OR=2.87, 95%CI: 2.31–3.57), being retreated (OR=1.63, 95%CI: 1.24–2.14), being etiological positive (OR=2.50, 95% CI: 2.13–2.94), and being diagnosed initially at county level medical institution (OR=1.68, 95%CI: 1.38–2.05) were risk factors for unsuccessful treatment. Basic case management (OR=0.68, 95%CI: 0.59–0.79) was a protective factor for successful treatment.

Conclusion The successful treatment rate of pulmonary TB in the elderly showed an upward trend in Gansu from 2018 to 2022. The treatment outcomes in men, those aged ＞70 years, re-treated patients, etiological positive patients, and those with initial diagnosis at the county level medical institutions were relatively poor. It is suggested to strengthen the supervision and management of medication in the treatment of pulmonary TB in the elderly to further increase the successful treatment rate and reduce the incidence of adverse outcomes.