Prognostic nutritional index as a predictor of mortality in nontuberculous mycobacterial lung disease

Abstract

Background: Although the association between nontuberculous mycobacterial lung disease (NTM-LD) and malnutrition is known, there are a few reports on the association between the nutritional score and death in patients with NTM-LD. This study investigated the association between the nutrition data at the time of NTM-LD diagnosis and death. Methods: A retrospective study was conducted for patients with NTM-LD who visited the Maebashi Red Cross Hospital from January 2014 to December 2018. The patients were divided into the survival and death groups and analyzed statistically. Results: The diagnostic criteria for NTM-LD were met by 150 patients. The median age was 70 years (range, 20-94 years). There were 51 (34.0%) men and 99 (66.0%) women. In the death group, the body mass index was significantly low, and there were significantly more patients with asthma. Further, computed tomography at the first visit revealed significantly fewer cases of the nodular bronchiectasis type. In the hematologic examination at the time of NTM-LD diagnosis, the white blood cell, neutrophil, and platelet counts and C-reactive protein and serum calcium levels were significantly higher in the death group, while the serum albumin level was significantly lower. In the death group, the prognostic nutritional index (PNI), calculated from the hematologic findings, was significantly lower, while the Glasgow Prognostic Score (GPS) was significantly higher. A logistic regression analysis was performed on items with significant differences, and the PNI and platelet count were independent factors predicting death. Conclusions: PNI might be effective as a prognostic factor for NTM-LD.

Incidence of Nontuberculous Mycobacterial Pulmonary Infection, by Ethnic Group, Hawaii, USA, 2005–2019

“…Risk was highest for clinically underweight beneficiaries compared with those with BMIs categorized as normal or overweight/obese. These findings of an increased risk for incident NTM with decreasing BMI is consistent with findings of other studies showing not only the role of low BMI in disease progression (25,26) but also in susceptibility to infection or disease. A recent study that used South Korea national insurance data and prospectively ascertained BMI and NTM-PD over 9 years (27) found that lower BMI at baseline as well as weight loss during the study period were associated with higher NTM-PD risk.…”

Differential Discontinuation Profiles between Pirfenidone and Nintedanib in Patients with Idiopathic Pulmonary Fibrosis

“…Statistical analyses were performed using the statistical software “EZR” (easy R), which was based on the R and R commander [ 16 , 17 ]. Comparisons of categorical data between the pirfenidone and nintedanib groups were performed using Fisher’s exact test.…”

The factors associated with mortality and progressive disease of nontuberculous mycobacterial lung disease: a systematic review and meta-analysis

“…A total of 7,103 patients from 23 studies were included in the review of factors associated with all-cause mortality 9 , 11 , 13 – 33 . The pooled adjusted RRs and unadjusted RRs, which estimated the association between factors and all-cause mortality, were visualized by forest plots (Fig.…”

“…Many observational studies have been conducted to identify the factors associated with mortality and progressive disease in NTM-LD; however, results vary depending on the study settings 9 , 10 . Moreover, evidence of these factors remains inconclusive as most of the research is underpowered 11 , 12 .…”