한빛사논문
- 조회376
Youlim Kim, MD1*; Jai Hoon Yoon, MD, PhD2*; Jiin Ryu, MS3*; Bumhee Yang, MD4; Sung Jun Chung, MD5; Hyung Koo Kang, MD6; Dong Won Park, MD, PhD5; Tai Sun Park, MD, PhD5; Ji-Yong Moon, MD, PhD5; Tae-Hyung Kim, MD, PhD5; Sang-Heon Kim, MD, PhD5; Jang Won Sohn, MD, PhD5; Ho Joo Yoon, MD, PhD5; Hyun Lee, MD, PhD5#; Hayoung Choi, MD, PhD7#
1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
2Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea.
3Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Republic of Korea.
4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
5Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea.
6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.
7Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
*Y. Kim, J.H. Yoon and J. Ryu contributed equally to this work.
#H. Lee and H. Choi also contributed equally to this work.
Correspondence to Hayoung Choi, M.D., Ph.D., Hyun Lee, M.D., Ph.D.
Abstract
Background
Gastroesophageal reflux disease (GERD) is a common comorbidity of non-tuberculous mycobacterial pulmonary disease (NTM-PD). Although GERD is associated with more symptoms and severe disease in patients with NTM-PD, whether GERD is associated with an increased risk of developing NTM-PD is unknown.
Research Question
Does GERD influence the development of NTM-PD? Are there any factors associated with an increased risk of NTM-PD among patients with GERD? What is the impact of NTM-PD on healthcare utilization of patients with GERD?
Study Design and Methods
Data from the Korean National Health Insurance Service-National Sample Cohort between 2002–2015 were used. The incidence and risk of NTM-PD were compared between patients with GERD (GERD cohort; n=17,424) and age, sex, type of insurance, and Charlson Comorbidity Index-matched patients (matched cohort; n=69,696). Using the GERD cohort, the factors associated with incident NTM-PD were also evaluated.
Results
During a median follow-up duration of 5.1 years, the age- and sex-adjusted incidence of NTM-PD was significantly higher in the GERD cohort (34.8/100,000 person-years, PY) than in the matched cohort (10.5/100,000 PY, P<0.001), with a subdistribution hazard ratio (HR) of 3.36 (95% confidence interval [CI]=2.10–5.37). Regarding risk factors associated with NTM-PD, age ≥ 60 years (adjusted HR=3.57, 95% CI=1.58–8.07) and bronchiectasis (adjusted HR=18.69, 95% CI=6.68–52.28) were associated with an increased risk of incident NTM-PD in the GERD cohort. Compared with patients with GERD who did not develop NTM-PD, those with NTM-PD showed higher all-cause (13,321 vs. 5,932 PY, P=0.049) and respiratory disease-related emergency department visits or hospitalization (5,403 vs. 801, P=0.011).
Interpretation
GERD is associated with an increased incidence of NTM-PD. Older age and bronchiectasis are risk factors for NTM-PD in patients with GERD. NTM-PD in patients with GERD is associated with increased healthcare utilization.
논문정보
- Research article
- 2022년 09월 (BRIC 등록일 2022-09-13)
- 국내 연구진
- 의약학 > 응용의학
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