Five-Year Outcomes Among U.S. Bronchiectasis and Nontuberculous Mycobacterial Registry Patients
Timothy R. Aksamit, Mayo Clinic, Rochester, MN
Nicholas Locantore, COPD Foundation, Washington, D.C.
Doreen Addrizzo-Harris, New York University School of Medicine, New York, NY
Juzar Ali, LSU Health Sciences Center - New Orleans
Alan Barker, Oregon Health & Science University, Portland, OR
Ashwin Basavaraj, New York University School of Medicine, New York, NY
Megan Behrman, University of Kansas Medical Center, Kansas City, KS
Amanda E. Brunton, COPD Foundation, Washington, D.C.
Sarah Chalmers, Mayo Clinic, Rochester, MN
Radmila Choate, University of Kentucky College of Public Health, Lexington, KY
Nathan C. Dean, Intermountain Medical Center, Murray, UT
Angela DiMango, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
David Fraulino, University of Connecticut School of Medicine, Farmington, CT
Margaret M. Johnson, Mayo Clinic, Jacksonville, FL
Nicole C. Lapinel, Northwell Health, New Hyde Park, NY
Diego J. Maselli, San Antonio Veterans Administration, San Antonio, TX
Pamela J. McShane, The University of Texas Health Science Center at Tyler, Tyler, TX
Mark L. Metersky, University of Connecticut School of Medicine, Farmington, CT
Bruce E. Miller, COPD Foundation, Washington, D.C.
Edward T. Naureckas, University of Chicago Department of Medicine, Chicago, IL
Anne E. O'Donnell, Georgetown University Medical Center, Washington, D.C.
Kenneth N. Olivier, The University of North Carolina at Chapel Hill, Chapel Hill, NC
Elly Prusinowski, University of Chicago Department of Medicine, Chicago, IL
Marcos I. Restrepo, San Antonio Veterans Administration, San Antonio, TX
Christopher J. Richards, Massachusetts General Hospital, Boston, MA
Gloria Rhyne, Oregon Health & Science University School of Medicine, Portland, OR
Andreas Schmid, University of Kansas Medical Center, Kansas City, KS
George M. Solomon, University of Alabama at Birmingham, Birmingham, AL
Ruth Tal-Singer, COPD Foundation, Washington, D.C.
et al
Abstract
RATIONALE: Nontuberculous mycobacteria (NTM) are prevalent among patients with bronchiectasis. However, the long-term natural history of patients with NTM and bronchiectasis is not well described. OBJECTIVE: To assess the impact of NTM on 5-year clinical outcomes and mortality in patients with bronchiectasis. METHODS: Patients in the United States Bronchiectasis and Nontuberculous Mycobacteria Research Registry with ≥5 years of follow-up were eligible. Data were collected for all-cause mortality, lung function, exacerbations, hospitalizations, and disease severity. Outcomes were compared between patients with and without NTM at baseline. Mortality was assessed using Cox proportional hazards models and the log-rank test. MEASUREMENTS AND MAIN RESULTS: In total, 2,634 patients were included: 1,549 (58.8%) with and 1,085 (41.2%) without NTM at baseline. All-cause mortality (95% confidence interval) at Year 5 was 12.1% (10.5%, 13.7%) overall, 12.6% (10.5%, 14.8%) in patients with NTM, and 11.5% (9.0%, 13.9%) in patients without NTM. Independent predictors of 5-year mortality were baseline forced expiratory volume in 1 second % predicted, age, hospitalization within 2 years before baseline, body mass index, and gender (all p<0.01). The probabilities of acquiring NTM or were approximately 4% and 3% per year, respectively. Spirometry, exacerbations, and hospitalizations were similar irrespective of NTM status, except that annual exacerbations were lower in patients with NTM (p<0.05). CONCLUSIONS: Outcomes including exacerbations, hospitalizations, rate of loss of lung function, and mortality rate were similar across 5 years in patients with bronchiectasis with or without NTM.
