한빛사논문
- 조회462
서울대학교병원
Kwonhyung Hyung 1, Sung-A Kim 1, Joong-Yub Kim 1, Nakwon Kwak 1, Jae-Joon Yim 1,2
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
Corresponding author: Jae-Joon Yim, M.D. Ph.D.
Abstract
Background: The clinical course of nontuberculous mycobacterial pulmonary disease (NTM-PD) is varied, and a watchful waiting management strategy is appropriate for a subset of patients. Understanding disease progression and risk factors for progression is essential for deciding on an appropriate follow-up strategy.
Research question: What is the rate of NTM-PD progression, and what are the predictors of progression?
Study design and methods: Patients with NTM-PD who were enrolled in a prospective observational cohort study between July 1, 2011, and December 31, 2022 were included in this analysis. Clinical, bacterial, laboratory, and radiographic data were collected at enrollment and then regularly during follow-up. NTM-PD progression was defined as either the initiation of treatment or the clinician's intention to treat. The rate of progression was calculated and the predictors for progression were analyzed.
Results: Of the 477 patients enrolled, NTM-PD progressed in 192 patients over a median follow-up of 5.4 years. The incidence of NTM-PD progression was 11.0 cases per 100 person-years (95% confidence interval [CI] 9.5-12.7). The proportion of patients experiencing disease progression was 21.4% at 1 year, 33.8% at 3 years, and 43.3% at 5 years. The final multivariable analysis model identified female sex (adjusted hazard ratio [aHR] 1.69, 95% CI 1.19-2.39), elevated erythrocyte sedimentation rate (aHR 1.79, 95% CI 1.31-2.43), percent predicted forced expiratory volume in 1 second (aHR 0.89, 95% CI 0.82-0.96), and the presence of a cavity (aHR 2.78, 95% CI 2.03-3.80) as predictors of progression.
Interpretation: About half of patients with NTM-PD experienced progression during an observation period of more than 5 years. Patients with risk factors for progression should be observed closely.
논문정보
- Research article
- 2024년 03월 (BRIC 등록일 2024-03-19)
- 국내 연구진
- 의약학 > 응용의학
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