TY - JOUR T1 - Development of a prognostic scoring system for <em>Mycobacterium avium</em> complex lung disease JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2016.PA2564 VL - 48 IS - suppl 60 SP - PA2564 AU - Shogo Kumagai AU - Akihiro Ito AU - Koji Furuuchi AU - Tadashi Ishida AU - Toru Hashimoto Y1 - 2016/09/01 UR - http://erj.ersjournals.com/content/48/suppl_60/PA2564.abstract N2 - 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 &lt;18.5 kg/m2, lymphocyte counts &lt;1000/µL, albumin &lt;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&lt;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&lt;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. ER -