Abstract
Limited data are available regarding the prognostic factors for patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). We investigated the prognostic factors associated with long-term mortality in NTM-PD patients after adjusting for individual confounders, including aetiological organism and radiological form.
A total of 1445 patients with treatment-naïve 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.
Abstract
The long-term mortality of patients with nontuberculous mycobacterial pulmonary disease was significantly associated with the aetiological organism, cavitary disease and certain demographic characteristics http://bit.ly/2kyXTHT
Footnotes
This article has supplementary material available from erj.ersjournals.com
This study is registered with ClinicalTrials.gov identifier: NCT00970801.
Author contributions: Study conception and design: B.W. Jhun, S.M. Moon and W-J. Koh. Data acquisition and analysis: B.W. Jhun, S.M. Moon, K. Jeon, O.J. Kwon, H. Yoo, K.C. Carriere, H.J. Huh, N.Y. Lee, S.J. Shin and W-J. Koh. Data interpretation and manuscript writing: B.W. Jhun, S.M. Moon and W-J. Koh. Critical revision and final approval of the manuscript: B.W. Jhun, S.M. Moon, K. Jeon, O.J. Kwon, H. Yoo, K.C. Carriere, H.J. Huh, N.Y. Lee, S.J. Shin, C.L. Daley and W-J. Koh.
Conflict of interest: B.W. Jhun has nothing to disclose.
Conflict of interest: S.M. Moon has nothing to disclose.
Conflict of interest: K. Jeon has nothing to disclose.
Conflict of interest: O.J. Kwon has nothing to disclose.
Conflict of interest: H. Yoo has nothing to disclose.
Conflict of interest: K.C. Carriere has nothing to disclose.
Conflict of interest: H.J. Huh has nothing to disclose.
Conflict of interest: N.Y. Lee has nothing to disclose.
Conflict of interest: S.J. Shin has nothing to disclose.
Conflict of interest: C.L. Daley reports grants from Insmed Inc., and has served on advisory boards for Insmed, Johnson & Johnson, Spero and Horizon, outside the submitted work.
Conflict of interest: W-J. Koh reports personal fees for consultancy from Insmed, outside the submitted work.
Support statement: This work was supported by the National Research Foundation of Korea (NRF) funded by the Korea government (MSIT) (NRF-2018R1A2A1A05018309). The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received April 20, 2019.
- Accepted September 18, 2019.
- Copyright ©ERS 2020