Institute of Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Republic of Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
Sci Rep. 2024 Oct 1;14(1):22815. doi: 10.1038/s41598-024-73768-z.
Patients with nontuberculous mycobacteria (NTM) infection have multiple comorbidities, but the impact of comorbidities on mortality are not well known. We aimed to compare the mortality between people with and without NTM infection and associated comorbidities and their prognostic value on mortality using National Health Insurance Service-National Sample Cohort data from 2006 to 2019. In this matched cohort study, people with and without NTM infection aged 20-89 years were matched 1:4 by sex, age, region, and income. The hazard ratios (HRs) with 95% confidence intervals (CIs) of mortality in patients with NTM infection were estimated using a Cox proportional hazard regression model. In total, 2421 patients with NTM infection (mean age, 54.8 years) and 9684 controls were included. NTM-infected patients had a significantly increased risk of mortality than matched controls in the multivariable model adjusted for age, sex, region, income, and Charlson comorbidity index (aHR = 1.88, 95% CI 1.65-2.14). Among patients with NTM infection, respiratory comorbidities including chronic obstructive pulmonary disease, asthma, interstitial lung disease, and moderate to severe liver disease and malignancy were positively associated with mortality. NTM infection was independently associated with an increased risk of mortality, and mortality risk in patients with NTM infection may be increased by coexisting comorbidities.
非结核分枝杆菌(NTM)感染患者存在多种合并症,但合并症对死亡率的影响尚不清楚。我们旨在利用 2006 年至 2019 年国家健康保险服务-国家样本队列数据,比较有和无 NTM 感染及相关合并症患者的死亡率,并评估其对死亡率的预后价值。在这项匹配队列研究中,将年龄在 20-89 岁之间的有和无 NTM 感染的患者按照性别、年龄、地区和收入进行 1:4 匹配。使用 Cox 比例风险回归模型估计 NTM 感染患者死亡的风险比(HR)及其 95%置信区间(CI)。共纳入 2421 例 NTM 感染患者(平均年龄 54.8 岁)和 9684 例对照。在调整年龄、性别、地区、收入和 Charlson 合并症指数后,多变量模型显示 NTM 感染患者的死亡率明显高于匹配对照组(aHR=1.88,95%CI 1.65-2.14)。在 NTM 感染患者中,与呼吸相关的合并症,包括慢性阻塞性肺疾病、哮喘、间质性肺疾病、中重度肝病和恶性肿瘤,与死亡率呈正相关。NTM 感染与死亡率增加独立相关,并且 NTM 感染患者的死亡率风险可能因合并症而增加。