Nontuberculosis Mycobacterium Disease is a Risk Factor for Chronic Obstructive Pulmonary Disease: A Nationwide Cohort Study

Yeh, Jun-Jun; Wang, Yu-Chiao; Sung, Fung‐Chang; Chou, Christine Yi-Ting; Kao, Chia‐Hung

doi:10.1007/s00408-014-9574-9

Cited by 23 publications

(16 citation statements)

References 42 publications

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“…[4,18,19] Smoking is not only a risk factor for primary spontaneous pneumothorax and pneumothorax recurrence, [7] but also affects the development of COPD, especially in patients with NTMPD. [20] Therefore, smoking may also increase pneumothorax in patients with NTMPD. Although the disease and treatment duration and treatment status varied in our study, 9 of 10 patients who were diagnosed with NTMPD with the onset of pneumothorax had underlying pulmonary disease, particularly COPD.…”

Section: Discussionmentioning

confidence: 99%

Pneumothorax associated with nontuberculous mycobacteria

et al. 2016

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The incidence of nontuberculous mycobacterial pulmonary disease (NTMPD) is increasing worldwide. Secondary spontaneous pneumothorax occurs as a complication of underlying lung disease and is associated with higher morbidity, mortality, and recurrence than primary spontaneous pneumothorax. We here investigated the clinical features and long-term outcomes of pneumothorax associated with NTMPD.We conducted a retrospective study on consecutive adult patients with pneumothorax associated with NTMPD at Fukujuji Hospital and Keio University Hospital from January 1992 to December 2013. We reviewed the medical records of 69 such patients to obtain clinical characteristics, radiological findings, and long-term outcomes, including pneumothorax recurrence and mortality.The median age of the patients was 68 years; 34 patients were women. The median body mass index was 16.8 kg/m2. Underlying pulmonary diseases mainly included chronic obstructive pulmonary disease and pulmonary tuberculosis. On computed tomography, nodules and bronchiectasis were observed in 46 (98%) and 45 (96%) patients, respectively. Consolidation, pleural thickening, interlobular septal thickening, and cavities were most common, and observed in 40 (85%), 40 (85%), 37 (79%), and 36 (77%) patients, respectively. Regarding pneumothorax treatment outcomes, complete and incomplete lung expansion were observed in 49 patients (71%) and 15 patients (22%), respectively. The survival rate after pneumothorax was 48% at 5 years. By the end of the follow-up, 33 patients had died, and the median survival was 4.4 years with a median follow-up period of 1.7 years. The rate of absence of recurrence after the first pneumothorax was 59% at 3 years. By the end of the follow-up, 18 patients had experienced pneumothorax recurrence. Furthermore, 12/18 patients (66%) with recurrent pneumothorax died during the study period. Twenty-three patients (70%) died because of NTMPD progression. Low body mass index (BMI) was a negative prognostic factor for pneumothorax associated with NTMPD in multivariate analysis (HR 0.79, 95% CI 0.64−0.96; P = 0.018)Patients with pneumothorax associated with NTMPD have advanced disease, a high rate of pneumothorax recurrence, and poor prognosis, regardless of the pneumothorax treatment used. Further improvements in early diagnosis of NTMPD and appropriate management in both NTMPD and NTMPD-associated pneumothorax are needed.

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Section: Discussionmentioning

confidence: 99%

Pneumothorax associated with nontuberculous mycobacteria

et al. 2016

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“…It has also been reported that patients with an earlier diagnosis of NTM disease, associated with both MAC and non-MAC NTM infection, had a higher likelihood of presenting with COPD in follow-up examinations (adjusted HR of 3.57 [95% CI: 2.56e4.97] for women and 2.89 [95% CI: 2.31e3.61] for men) [48]. Furthermore, COPD patients with multiple and single NTM isolates, that included, in order of frequency MAC, Mycobacterium abscessus, Mycobacterium chelonae, Mycobacterium fortuitum, and M. kansasii, were approximately twice as likely to be admitted with acute COPD exacerbations at least once a year during the follow-up period compared to COPD patients from whom no NTM were isolated [49].…”

Section: Tb and Subsequent Copd Susceptibilitymentioning

confidence: 92%

TB meets COPD: An emerging global co-morbidity in human lung disease

2015

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“…It has been reported even with non‐tuberculosis mycobacterium (NTM) species. Yeh et al in a Taiwanese cohort of 3005 NTM patients showed that NTM patients have 3.08‐fold increased risk of developing COPD compared with the non‐NTM cohort. Patients of NTM with abnormal pulmonary function initially showed improvement after macrolides therapy .…”

Section: Introductionmentioning

confidence: 99%