Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and.
Am J Respir Crit Care Med. 2021 Jan 15;203(2):230-236. doi: 10.1164/rccm.202004-1418OC.
Because the prognosis of nontuberculous mycobacterial pulmonary disease varies, a scoring system predicting mortality is needed. We aimed to develop a novel scoring system to predict mortality among patients with nontuberculous mycobacterial pulmonary disease. We included patients age ≥20 years with newly diagnosed nontuberculous mycobacterial pulmonary disease, with , , subsp. , or subsp. . Cox proportional hazards models were used to identify predictors of mortality in a derivation cohort, and a scoring system was developed. It was validated in an independent prospective cohort. A total 1,181 and 377 patients were included in the derivation and validation cohorts, respectively. In the final model, body mass index <18.5 kg/m (1 point), age ≥65 years (1 point), presence of cavity (1 point), elevated erythrocyte sedimentation rate (1 point), and male sex (1 point) were selected as predictors for mortality. We named this novel scoring system BACES (body mass index, age, cavity, erythrocyte sedimentation rate, and sex). Harrell's C-index for the BACES score was 0.812 (95% confidence interval, 0.786-0.837) in the derivation cohort and 0.854 (95% confidence interval, 0.797-0.911) in the validation cohort, indicating excellent discrimination performance. The estimated 5-year risk of mortality was 1.2% with BACES score 0 and 82.9% with BACES score 5. We developed the BACES score, which could accurately predict mortality among patients with nontuberculous mycobacterial pulmonary disease caused by , , subsp. , or subsp. .
由于非结核分枝杆菌肺病的预后各不相同，因此需要一种预测死亡率的评分系统。我们旨在开发一种新的评分系统，以预测非结核分枝杆菌肺病患者的死亡率。我们纳入了年龄≥20 岁、新诊断为非结核分枝杆菌肺病、分枝杆菌复合群、脓肿分枝杆菌亚种、堪萨斯分枝杆菌亚种或海分枝杆菌亚种的患者。Cox 比例风险模型用于确定发病队列中死亡率的预测因素，并制定了评分系统。该评分系统在一个独立的前瞻性队列中进行了验证。总计 1181 例和 377 例患者分别纳入了发病队列和验证队列。在最终模型中，选择了以下预测死亡率的因素：体重指数<18.5kg/m²（1 分）、年龄≥65 岁（1 分）、有空洞（1 分）、红细胞沉降率升高（1 分）和男性（1 分）。我们将这个新的评分系统命名为 BACES（体重指数、年龄、空洞、红细胞沉降率和性别）。BACES 评分在发病队列中的 Harrell's C 指数为 0.812（95%置信区间，0.786-0.837），在验证队列中的为 0.854（95%置信区间，0.797-0.911），表明其具有良好的区分能力。BACES 评分 0 分的患者 5 年死亡率估计为 1.2%，BACES 评分 5 分的患者 5 年死亡率估计为 82.9%。我们开发的 BACES 评分可准确预测由脓肿分枝杆菌亚种、堪萨斯分枝杆菌亚种、海分枝杆菌亚种或分枝杆菌复合群引起的非结核分枝杆菌肺病患者的死亡率。
