Factors associated with lung function decline in patients with non-tuberculous mycobacterial pulmonary disease

PLoS One. 2013;8(3):e58214. doi: 10.1371/journal.pone.0058214. Epub 2013 Mar 6.

Abstract

Background: There is paucity of risk factors on lung function decline among patients with non-tuberculous mycobacteria (NTM) pulmonary disease in literature.

Methods: Patients with NTM pulmonary disease between January 2000 and April 2011 were retrospectively selected. Sixty-eight patients had at least two pulmonary function tests within a mean follow-up period of 47 months.

Results: Sixty-eight patients were included. They had a median age of 65 years and 65% had impaired lung function (Forced expiratory volume in 1 second [FEV1] <80% of predicted value). The mean FEV1 decline was 48 ml/year. By linear regression, younger age (beta: 0.472, p<0.001), initial FEV1>50% of predicted value (beta: 0.349, p = 0.002), male sex (beta: 0.295, p = 0.018), bronchiectasis pattern (beta: 0.232, p = 0.035), and radiographic score >3 (beta: 0.217, p = 0.049) were associated with greater FEV1 decline. Initial FEV1>50% of predicted value (beta: 0.263, p = 0.032) was also associated with greater FVC annual decline, whereas M. kansasii pulmonary disease was marginally associated with greater annual FVC decline (beta: 0.227, p = 0.062).

Conclusions: NTM pulmonary disease is associated with greater decline in lung function in patients who are young, male, with bronchiectasis, and with a high radiographic score. Special attention should be given to patients with these risk factors.

MeSH terms

  • Age Factors
  • Aged
  • Bronchiectasis / complications
  • Bronchiectasis / physiopathology*
  • Female
  • Forced Expiratory Flow Rates
  • Humans
  • Linear Models
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / epidemiology*
  • Lung Diseases / etiology
  • Lung Diseases / physiopathology*
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / diagnostic imaging
  • Mycobacterium Infections, Nontuberculous / physiopathology*
  • Radiography
  • Retrospective Studies
  • Risk Factors
  • Sex Factors

Grants and funding

The authors have no support or funding to report.