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Impact of prognostic nutritional index on outcomes in patients with Mycobacterium avium complex pulmonary disease

 Sung Woo Moon  ;  Eun Hye Lee  ;  Ji Soo Choi  ;  Ah Young Leem  ;  Su Hwan Lee  ;  Sang Hoon Lee  ;  Song Yee Kim  ;  Kyung Soo Chung  ;  Ji Ye Jung  ;  Moo Suk Park  ;  Young Sam Kim  ;  Young Ae Kang 
 PLOS ONE, Vol.15(5) : e0232714, 2020-05 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Anti-Bacterial Agents / therapeutic use* ; Female ; Humans ; Kaplan-Meier Estimate ; Lung Diseases / diagnosis ; Lung Diseases / drug therapy* ; Lung Diseases / microbiology* ; Lung Diseases / mortality ; Male ; Malnutrition / diagnosis* ; Malnutrition / mortality ; Middle Aged ; Mycobacterium avium Complex* ; Mycobacterium avium-intracellulare Infection / diagnosis ; Mycobacterium avium-intracellulare Infection / drug therapy* ; Mycobacterium avium-intracellulare Infection / microbiology ; Mycobacterium avium-intracellulare Infection / mortality ; Nutrition Assessment* ; Nutritional Status ; Prognosis ; Quality of Life ; Retrospective Studies ; Risk Factors ; Sputum / microbiology ; Treatment Outcome
Onodera's prognostic nutritional index (PNI) is useful in predicting prognosis of various diseases. But the usefulness of PNI in non-surgical patients has not been sufficiently proven yet. In patients with mycobacterium avium complex pulmonary disease (MAC-PD), malnutrition is an important factor that affects the quality of life and morbidity. Here, we aimed to evaluate whether PNI is related with clinical outcomes in MAC-PD patients. We examined 663 patients diagnosed with MAC-PD between May 2005 and November 2017. PNI score was calculated at the time of diagnosis and treatment initiation, and patients were divided into malnutrition and non-malnutrition groups according to a cut-off PNI score of 45. As the recommended duration of treatment for MAC-PD is 12 months following sputum conversion, treatment duration less than 12 months was defined as treatment intolerance. Survivals were compared with the log-rank test. Multivariate logistic regression and multivariate Cox proportional hazards models were used to estimate the odds ratio (OR) and hazards ratio (HR) for treatment intolerance and mortality, respectively. Of the 306 patients that received treatment, 193 received treatment longer than 12 months. In the multivariable logistic regression model, malnutrition at the time of treatment initiation was related with treatment intolerance (OR: 2.559, 95% confidence interval [CI]: 1.414-4.634, P = 0.002). Patients in the malnutrition group at the time of diagnosis exhibited lower survival (P<0.001) and malnutrition at the time of diagnosis was a significant risk for all-cause mortality (HR: 2.755, 95% CI: 1.610-4.475, P<0.001). Malnutrition, as defined by PNI, is an independent predictor for treatment intolerance and all-cause mortality in patients with MAC-PD.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Moon, Sung Woo(문성우) ORCID logo https://orcid.org/0000-0001-9917-9802
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Lee, Sang Hoon(이상훈) ORCID logo https://orcid.org/0000-0002-7706-5318
Lee, Su Hwan(이수환) ORCID logo https://orcid.org/0000-0002-3487-2574
Lee, Eun Hye(이은혜) ORCID logo https://orcid.org/0000-0003-2570-3442
Leem, Ah Young(임아영) ORCID logo https://orcid.org/0000-0001-5165-3704
Jung, Kyung Soo(정경수) ORCID logo https://orcid.org/0000-0003-1604-8730
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
Choi, Ji Soo(최지수) ORCID logo https://orcid.org/0000-0003-2716-6775
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