title: Prognostic factors of 634 HIV-negative patients with Mycobacterium avium complex lung disease.
abstract: BACKGROUND
  The prognostic factors of Mycobacterium avium complex lung disease (MAC-LD) are not clearly defined.
  
  
  OBJECTIVE
  To assess the prognostic factors of all-cause and MAC-specific mortality in patients with MAC-LD, especially in accordance with radiographic features, first-line treatment, and host predisposition.
  
  
  METHODS
  Medical records of 634 HIV-negative patients with MAC-LD treated at our institution in Saitama, Japan were retrospectively analyzed.
  
  
  RESULTS
  Patients' mean age was 68.9 years, and median follow-up period was 4.7 years. Radiographic features included nodular/bronchiectatic (NB) disease: 482 patients (76.0%); fibrocavitary (FC) disease: 105 patients (16.6%); FC+NB disease: 30 patients (4.7%); and other types: 17 patients (3.0%). First-line treatments were observation or one drug: 479 patients (75.6%); 2 to 5 drugs: 131 patients (20.7%); and unknown: 24 patients (3.8%). A multivariate Cox proportional hazard model showed male sex, older age, presence of systemic and/or respiratory comorbidity, non-NB radiographic features, body mass index (BMI) less than 18.5 kg/m(2), anemia, hypoalbuminemia, and erythrocyte sedimentation rate greater than or equal to 50 mm/h to be negative prognostic factors for all-cause mortality, and FC or FC+NB radiographic features, BMI less than 18.5 kg/m(2), anemia, and C-reactive protein greater than or equal to 1.0 mg/dl to be negative prognostic factors for MAC-specific mortality.
  
  
  CONCLUSIONS
  The first-line treatment regimen was not associated with all-cause mortality. FC or FC+NB disease, BMI less than 18.5 kg/m(2), and anemia were negative prognostic factors for both all-cause and MAC-specific mortality.
authors.affiliation: Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Saitama, Japan. makotoh5558@yahoo.co.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Hayashi
authors.forename: Noboru
authors.initials: N
authors.lastname: Takayanagi
authors.forename: Tetsu
authors.initials: T
authors.lastname: Kanauchi
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Miyahara
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yanagisawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sugita
mesh_terms: D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D018023:HIV Seronegativity; D006801:Humans; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000000981:diagnostic imaging / Q000382:microbiology; D008171:Lung Diseases / Q000175:diagnosis / Q000382:microbiology*; D008297:Male; D015269:Mycobacterium avium Complex; D015270:Mycobacterium avium-intracellulare Infection / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D000900:Anti-Bacterial Agents