Clinically significant hemoptysis and all-cause mortality in patients with nontuberculous mycobacterial pulmonary disease - 03/02/25
Abstract |
Background |
Hemoptysis is one of the major symptoms in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). However, its prevalence, incidence, and impact on long-term prognosis remain uncertain. We evaluated the incidence of clinically significant hemoptysis, and determined its association with mortality in patients with NTM-PD.
Methods |
Patients enrolled in a prospective observational cohort (NCT01616745) between July 2011 and May 2023 were analyzed. We evaluated risk factors for clinically significant hemoptysis—defined as hemoptysis events requiring interventions such as bronchial artery embolization or surgical resection—and its association with all-cause mortality.
Results |
Among 506 patients from the ongoing cohort, 43 patients (8.5 %) experienced clinically significant hemoptysis during a median follow-up of 5.1 years. The overall incidence of clinically significant hemoptysis was 2.1 (95 % confidence interval [CI]; 1.5–2.9) cases per 100 person-years. Identified risk factors included a history of tuberculosis (incidence rate ratio [IRR], 1.91; 95 % CI, 1.02–3.60), higher C-reactive protein (CRP) (IRR, 1.20 for 1 mg/dl increase; 95 % CI, 1.01–1.43), and lower % predicted forced vital capacity (FVC) (IRR, 0.81 for 10 % increase; 95 % CI, 0.66–0.98). Clinically significant hemoptysis was independently associated with an increased risk of all-cause mortality (adjusted hazard ratio, 2.39; 95 % CI, 1.31–4.36).
Conclusion |
In patients with NTM-PD, those with history of tuberculosis, higher CRP levels, and lower % predicted FVC were at a higher risk of subsequent clinically significant hemoptysis. Importantly, clinically significant hemoptysis was associated with an elevated risk of all-cause mortality.
Clinical trial registration |
ClinicalTrials.gov; No.: NCT01616745.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The incidence of clinically significant hemoptysis in patients with NTM-PD was 2.1 cases per 100 person-years. |
• | A history of tuberculosis, elevated CRP levels, and lower % predicted FVC were identified as risk factors. |
• | Clinically significant hemoptysis was an independent risk factor for all-cause mortality in patients with NTM-PD. |
Keywords : Mycobacterium infections, Nontuberculous, Hemoptysis, Cohort studies
Plan
| ☆ | Conference presentation: Part of this research was presented at the Korean Academy of Tuberculosis and Respiratory Diseases International Conference in 2023. |
Vol 237
Article 107946- février 2025 Retour au numéro
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