非结核分枝杆菌肺病的死亡率及死亡原因

Mortality and causes of death in non-tuberculous mycobacterial pulmonary disease.

作者信息

Pedersen A A, Dahl V N, Løkke A, Holden I K, Fløe A, Ibsen R, Johansen I S, Hilberg O

机构信息

Department of Medicine, Lillebaelt Hospital, Vejle, Denmark;, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark;, Mycobacterial Centre for Research Southern Denmark (MyCRESD), Odense, Denmark.

International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark;, Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark;, Center for Global Health, Department of Public Health, Aarhus University (GloHAU), Aarhus, Denmark.

出版信息

Int J Tuberc Lung Dis. 2025 Feb 1;29(2):60-66. doi: 10.5588/ijtld.24.0365.

DOI:10.5588/ijtld.24.0365

PMID:39891334

Abstract

BACKGROUNDMortality and causes of death in non-tuberculous mycobacterial pulmonary disease (NTM-PD) are not well-described over long follow-up periods, particularly in Europe. We investigated whether NTM-PD is associated with higher mortality rates and different causes of death than matched controls.METHODSDanish national registers were used to identify patients with NTM-PD from 2000-2017 and to match them 1:4 with controls based on age, sex, cohabitation status, and municipality.RESULTSWe identified 661 patients with NTM-PD (50.4% male, median age 66 years, interquartile range [IQR] 48-84). The 5-year mortality rate for NTM-PD was 51% (95% CI 47-55) compared to 15% (95% CI 14-17) for controls. The hazard ratio (HR) of death for NTM-PD was 3.1 (95% CI 2.7-3.5; < 0.001) compared to controls, persisting after adjusting for Charlson Comorbidity Index with an adjusted HR of 1.9 (95% CI 1.63-2.22; < 0.001). Median age at death was 72 years (IQR 58-86) for NTM-PD patients and 81 years (IQR 69-93) for controls. Deaths due to respiratory diseases were more frequent in NTM-PD patients (45.2%) than in controls (11.6%). Mycobacterial infection directly caused death in 5.8% of NTM-PD patients.CONCLUSIONNTM-PD is associated with significantly higher all-cause mortality than controls, particularly in the initial years following diagnosis. These findings highlight the need for increased attention to NTM-PD and related respiratory conditions..

摘要

<标题>背景</标题>在较长的随访期内，非结核分枝杆菌肺病（NTM-PD）的死亡率和死亡原因尚未得到充分描述，尤其是在欧洲。我们调查了NTM-PD与匹配对照组相比是否具有更高的死亡率和不同的死亡原因。<标题>方法</标题>利用丹麦国家登记册确定2000年至2017年期间患有NTM-PD的患者，并根据年龄、性别、同居状况和直辖市将他们与对照组按1:4进行匹配。<标题>结果</标题>我们确定了661例NTM-PD患者（男性占50.4%，中位年龄66岁，四分位间距[IQR]为48-84）。NTM-PD的5年死亡率为51%（95%可信区间47-55），而对照组为15%（95%可信区间14-17）。与对照组相比，NTM-PD的死亡风险比（HR）为3.1（95%可信区间2.7-3.5；P<0.001），在根据查尔森合并症指数进行调整后仍然存在，调整后的HR为1.9（95%可信区间1.63-2.22；P<0.001）。NTM-PD患者的中位死亡年龄为72岁（IQR 58-86），对照组为81岁（IQR 69-93）。NTM-PD患者中因呼吸系统疾病导致的死亡比对照组更频繁（45.2%）。5.8%的NTM-PD患者直接死于分枝杆菌感染。<标题>结论</标题>NTM-PD与对照组相比，全因死亡率显著更高，尤其是在诊断后的最初几年。这些发现凸显了对NTM-PD及相关呼吸系统疾病增加关注的必要性。