@article {KumagaiPA2564, author = {Shogo Kumagai and Akihiro Ito and Koji Furuuchi and Tadashi Ishida and Toru Hashimoto}, title = {Development of a prognostic scoring system for Mycobacterium avium complex lung disease}, volume = {48}, number = {suppl 60}, elocation-id = {PA2564}, year = {2016}, doi = {10.1183/13993003.congress-2016.PA2564}, publisher = {European Respiratory Society}, abstract = {Introduction: There are no reports of a prognostic scoring system stratifying long-term survival in Mycobacterium avium complex lung disease (MAC-LD), which has a heterogeneous prognosis.Objectives: We sought to determine prognostic factors for MAC-LD and to develop a prognostic scoring system.Methods: We retrospectively reviewed data from 368 patients newly diagnosed with MAC-LD between 2006 and 2011 at Kurashiki Central Hospital. Overall survival (OS) was evaluated with Cox proportional hazards models to develop a prognostic scoring system. We also assessed the OS and MAC-LD-specific survival of three risk groups defined according to the prognostic scoring system, employing a two-tailed log-rank test.Results: Seven risk factors independently predictive for OS were identified by a multivariate analysis to derive a prognostic scoring system: male sex, age >=70 years, malignancy, body mass index \<18.5 kg/m2, lymphocyte counts \<1000/{\textmu}L, albumin \<3.5g/dL, and fibrocavitary disease. The area under the receiver operating curve of the prognostic scoring system for mortality was 0.84 (95\% confidence interval, 0.80{\textendash}0.89). Stratifying patients into low-risk (none or one factor), intermediate-risk (two or three factors), and high-risk (more than three factors) groups showed 5-year OS of 97.6\% (92.6{\textendash}99.2\%; n=147), 76.6\% (66.4{\textendash}84.1\%; n=154), and 30.8\% (16.4{\textendash}46.4\%, n=67), respectively (P\<0.001), and 5-year MAC-LD-specific survival of 99.0\% (92.9-99.9\%), 89.3\% (82.9-97.4\%), and 54.4\% (32.2-72.1\%), respectively (P\<0.001).Conclusions: Our prognostic scoring system with seven risk factors is the first simple predictive tool for MAC-LD prognosis and may aid in improving treatment strategies.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/48/suppl_60/PA2564}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }