TY - JOUR T1 - Prognostic factors associated with long-term mortality in 1445 patients with nontuberculous mycobacterial pulmonary disease: a 15-year follow-up study JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00798-2019 SP - 1900798 AU - Byung Woo Jhun AU - Seong Mi Moon AU - Kyeongman Jeon AU - O Jung Kwon AU - Heejin Yoo AU - Keumhee C. Carriere AU - Hee Jae Huh AU - Nam Yong Lee AU - Sung Jae Shin AU - Charles L. Daley AU - Won-Jung Koh Y1 - 2019/01/01 UR - http://erj.ersjournals.com/content/early/2019/09/19/13993003.00798-2019.abstract N2 - 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 etiologic 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 etiologic 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 etiological 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 gender, low body mass index, chronic pulmonary aspergillosis, pulmonary or extrapulmonary malignancy, chronic heart or liver disease, and erythrocyte sedimentation rate. The etiologic organism was also significantly associated with mortality: M. intracellulare (adjusted hazard ratio [aHR]=1.40; 95% confidence interval [CI]=1.03–1.91); M. abscessus (aHR=2.19; 95% CI=1.36–3.51; and M. massiliense (aHR=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 cavitary nodular bronchiectatic form (aHR=1.70; 95% CI=1.12–2.59) and for fibrocavitary form (aHR=2.12; 95%CI=1.57–3.08), compared to non-cavitary nodular bronchiectatic form.The long-term mortality in patients with NTM-PD was significantly associated with the etiologic NTM organism, cavitary disease, and certain demographic characteristics.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Jhun has nothing to disclose.Conflict of interest: Dr. Moon has nothing to disclose.Conflict of interest: Dr. Jeon has nothing to disclose.Conflict of interest: Dr. Kwon has nothing to disclose.Conflict of interest: Dr. Yoo has nothing to disclose.Conflict of interest: Dr. Carriere has nothing to disclose.Conflict of interest: Dr. Huh has nothing to disclose.Conflict of interest: Dr. Lee has nothing to disclose.Conflict of interest: Dr. Shin has nothing to disclose.Conflict of interest: Dr. Daley reports grants and personal fees from Insmed, Johnson and Johnson, Spero, and Horizon, outside the submitted work.Conflict of interest: Dr. Koh reports personal fees from Insmed, outside the submitted work. ER -