%0 Journal Article %A Shogo Kumagai %A Akihiro Ito %A Koji Furuuchi %A Tadashi Ishida %A Toru Hashimoto %T Development of a prognostic scoring system for Mycobacterium avium complex lung disease %D 2016 %R 10.1183/13993003.congress-2016.PA2564 %J European Respiratory Journal %P PA2564 %V 48 %N suppl 60 %X 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/µL, 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, 0.80–0.89). 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% (92.6–99.2%; n=147), 76.6% (66.4–84.1%; n=154), and 30.8% (16.4–46.4%, 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. %U