The clinical course of nontuberculous mycobacterial pulmonary disease (NTM-PD) is varied, and a watchful waiting management strategy is appropriate for a subset of patients. Understanding disease progression and risk factors for progression is essential for deciding on an appropriate follow-up strategy. What is the rate of NTM-PD progression, and what are the predictors of progression? Patients with NTM-PD who were enrolled in a prospective observational cohort study between July 1, 2011, and December 31, 2022, were included in this analysis. Clinical, bacterial, laboratory, and radiographic data were collected at enrollment and then regularly during follow-up. NTM-PD progression was defined as either the initiation of treatment or the clinician’s intention to treat. The rate of progression was calculated and the predictors for progression were analyzed. Of the 477 patients enrolled, NTM-PD progressed in 192 patients over a median follow-up of 5.4 years. The incidence of NTM-PD progression was 11.0 cases per 100 person-years (95% CI, 9.5-12.7 cases per 100 person-years). The proportion of patients experiencing disease progression was 21.4% at 1 year, 33.8% at 3 years, and 43.3% at 5 years. The final multivariable analysis model identified female sex (adjusted hazard ratio [aHR], 1.69; 95% CI, 1.19-2.39), elevated erythrocyte sedimentation rate (aHR, 1.79; 95% CI, 1.31-2.43), FEV % predicted (aHR, 0.89; 95% CI, 0.82-0.96), and the presence of a cavity (aHR, 2.78; 95% CI, 2.03-3.80) as predictors of progression. About half of patients with NTM-PD experienced progression during an observation period of > 5 years. Patients with risk factors for progression should be observed closely. ; No.: ; URL:

中文翻译：

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非结核分枝杆菌肺部疾病患者的进展率和危险因素：前瞻性队列研究的二次分析

非结核分枝杆菌肺病 (NTM-PD) 的临床病程各不相同，观察等待管理策略适合部分患者。了解疾病进展和进展的危险因素对于决定适当的随访策略至关重要。 NTM-PD 进展率是多少？进展的预测因素是什么？本分析纳入了 2011 年 7 月 1 日至 2022 年 12 月 31 日期间参加前瞻性观察队列研究的 NTM-PD 患者。在入组时收集临床、细菌、实验室和放射学数据，然后在随访期间定期收集。 NTM-PD 进展被定义为治疗的开始或临床医生的治疗意图。计算进展率并分析进展的预测因素。在 477 名入组患者中，192 名患者在中位随访时间 5.4 年中出现 NTM-PD 进展。 NTM-PD 进展的发生率为每 100 人年 11.0 例（95% CI，每 100 人年 9.5-12.7 例）。 1 年时出现疾病进展的患者比例为 21.4%，3 年时为 33.8%，5 年时为 43.3%。最终的多变量分析模型确定了女性性别（调整后的风险比 [aHR]，1.69；95% CI，1.19-2.39）、红细胞沉降率升高（aHR，1.79；95% CI，1.31-2.43）、预测的 FEV%（aHR，1.31-2.43） ，0.89；95% CI，0.82-0.96）和空洞的存在（aHR，2.78；95% CI，2.03-3.80）作为进展的预测因子。大约一半的 NTM-PD 患者在超过 5 年的观察期内经历了进展。应密切观察有进展危险因素的患者。 ;不。： ;网址：