Prognostic factors associated with long-term mortality in 1445 patients with nontuberculous mycobacterial pulmonary disease: a 15-year follow-up study

被引：133

作者：

Jhun, Byung Woo ^{[1
]}

Moon, Seong Mi ^{[2
]}

Jeon, Kyeongman ^{[1
]}

Kwon, O. Jung ^{[1
]}

Yoo, Heejin ^{[3
]}

Carriere, Keumhee C. ^{[3
,4
]}

Huh, Hee Jae ^{[5
]}

Lee, Nam Yong ^{[5
]}

Shin, Sung Jae ^{[6
,7
,8
]}

Daley, Charles L. ^{[9
,10
]}

Koh, Won-Jung ^{[1
]}

机构：

[1] Sungkyunkwan Univ, Samsung Med Ctr, Dept Med, Div Pulm & Crit Care Med,Sch Med, Seoul, South Korea

[2] Sungkyunkwan Univ, Samsung Changwon Hosp, Dept Med, Div Pulm & Crit Care Med,Sch Med, Chang Won, South Korea

[3] Samsung Med Ctr, Stat & Data Ctr, Seoul, South Korea

[4] Univ Alberta, Dept Math & Stat Sci, Edmonton, AB, Canada

[5] Sungkyunkwan Univ, Samsung Med Ctr, Dept Lab Med & Genet, Sch Med, Seoul, South Korea

[6] Yonsei Univ, Dept Microbiol, Coll Med, Seoul, South Korea

[7] Yonsei Univ, Inst Immunol & Immunol Dis, Coll Med, Seoul, South Korea

[8] Yonsei Univ, Brain Korea 21 Plus Project Med Sci, Coll Med, Seoul, South Korea

[9] Natl Jewish Hlth, Div Mycobacterial & Resp Infect, Dept Med, Denver, CO USA

[10] Univ Colorado, Dept Med, Aurora, CO USA

来源：

EUROPEAN RESPIRATORY JOURNAL | 2020年 / 55卷 / 01期

基金：

新加坡国家研究基金会;

关键词：

CLINICAL-SIGNIFICANCE; TREATMENT OUTCOMES; AVIUM; THERAPY; DIFFERENTIATION; EPIDEMIOLOGY; MASSILIENSE; INFECTIONS; DIAGNOSIS;

D O I：

10.1183/13993003.00798-2019

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Limited data are available regarding the prognostic factors for patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). We investigated the prognostic factors associated with longterm mortality in NTM-PD patients after adjusting for individual confounders, including aetiological organism and radiological form. A total of 1445 patients with treatment-naive NTM-PD who were newly diagnosed between July 1997 and December 2013 were included. The aetiological organisms were as follows: Mycobacterium avium (n=655), M. intracellulare (n=487), M. abscessus (n=129) and M. massiliense (n=174). The factors associated with mortality in NTM-PD patients were analysed using a multivariable Cox model after adjusting for demographic, radiological and aetiological data. The overall 5-, 10-and 15-year cumulative mortality rates for the NTM-PD patients were 12.4%, 24.0% and 36.4%, respectively. On multivariable analysis, the following factors were significantly associated with mortality in NTM-PD patients: old age, male sex, low body mass index, chronic pulmonary aspergillosis, pulmonary or extrapulmonary malignancy, chronic heart or liver disease and erythrocyte sedimentation rate. The aetiological organism was also significantly associated with mortality: M. intracellulare had an adjusted hazard ratio (aHR) of 1.40, 95% CI 1.03-1.91; M. abscessus had an aHR of 2.19, 95% CI 1.36-3.51; and M. massiliense had an aHR of 0.99, 95% CI 0.61-1.64, compared to M. avium. Mortality was also significantly associated with the radiological form of NTM-PD for the cavitary nodular bronchiectatic form (aHR 1.70, 95% CI 1.12-2.59) and the fibrocavitary form (aHR 2.12, 95% CI 1.57-3.08), compared to the non-cavitary nodular bronchiectatic form. Long-term mortality in patients with NTM-PD was significantly associated with the aetiological NTM organism, cavitary disease and certain demographic characteristics.

引用

页数：9

共 40 条

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