Clinical Implications of Size of Cavities in Patients With Nontuberculous Mycobacterial Pulmonary Disease: A Single-Center Cohort Study
Open Access
- 24 February 2021
- journal article
- research article
- Published by Oxford University Press (OUP) in Open Forum Infectious Diseases
- Vol. 8 (3), ofab087
- https://doi.org/10.1093/ofid/ofab087
Abstract
The presence of cavities is associated with unfavorable prognosis in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). However, little is known about the characteristics of such cavities and their impact on clinical outcomes. The aim of this study was to investigate the size of cavities and their implications on treatment outcomes and mortality in patients with NTM-PD. We included patients diagnosed with NTM-PD at Seoul National University Hospital between January 1, 2007, and December 31, 2018. We measured the size of cavities on chest computed tomography scans performed at the time of diagnosis and used multivariable logistic regression and Cox proportional hazards regression analysis to investigate the impact of these measurements on treatment outcomes and mortality. The study cohort comprised 421 patients (noncavitary, n = 329; cavitary, n = 92) with NTM-PD. During a median follow-up period of 49 months, 118 (35.9%) of the 329 patients with noncavitary and 64 (69.6%) of the 92 patients with cavitary NTM-PD received antibiotic treatment. Cavities >2 cm were associated with worse treatment outcomes (adjusted odds ratio, 0.41; 95% CI, 0.17–0.96) and higher mortality (adjusted hazard ratio, 2.52; 95% CI, 1.09–5.84), while there was no difference in treatment outcomes or mortality between patients with cavities ≤2 cm and patients with noncavitary NTM-PD. Clinical outcomes are different according to the size of cavities in patients with cavitary NTM-PD; thus, the measurement of the size of cavities could help in making clinical decisions.Funding Information
- VHS Medical Center Research Grant, Republic of Korea (VHSMC20047)
This publication has 33 references indexed in Scilit:
- Population-based Incidence of Pulmonary Nontuberculous Mycobacterial Disease in Oregon 2007 to 2012Annals of the American Thoracic Society, 2015
- Clinical characteristics and treatment outcomes of chronic pulmonary aspergillosisMedical Mycology, 2013
- Nodular Bronchiectatic Mycobacterium avium Complex Pulmonary Disease. Natural Course on Serial Computed Tomographic ScansAnnals of the American Thoracic Society, 2013
- Prognostic Factors of 634 HIV-Negative Patients with Mycobacterium avium Complex Lung DiseaseAmerican Journal of Respiratory and Critical Care Medicine, 2012
- rpoB sequence-based identification of Mycobacterium avium complex speciesMicrobiology, 2008
- Cavitary Pulmonary DiseaseClinical Microbiology Reviews, 2008
- Mycobacterium avium complex disease: prognostic implication of high-resolution computed tomography findingsEuropean Respiratory Journal, 2008
- Fleischner Society: Glossary of Terms for Thoracic ImagingRadiology, 2008
- An Official ATS/IDSA Statement: Diagnosis, Treatment, and Prevention of Nontuberculous Mycobacterial DiseasesAmerican Journal of Respiratory and Critical Care Medicine, 2007
- Hypothesis on the Evolution of Cavitary Lesions in Nontuberculous Mycobacterial Pulmonary Infection: Thin-Section CT and Histopathologic CorrelationAmerican Journal of Roentgenology, 2005