Prognostic nutritional index as a predictor of mortality in nontuberculous mycobacterial lung disease

Yoshimasa Hachisu; Keisuke Murata; Kousuke Takei; Takuma Tsuchiya; Hiroaki Tsurumaki; Yasuhiko Koga; Takeo Horie; Atsushi Takise; Takeshi Hisada

doi:10.21037/jtd-20-803

Prognostic nutritional index as a predictor of mortality in nontuberculous mycobacterial lung disease

J Thorac Dis. 2020 Jun;12(6):3101-3109. doi: 10.21037/jtd-20-803.

Authors

Yoshimasa Hachisu¹, Keisuke Murata¹, Kousuke Takei¹, Takuma Tsuchiya¹, Hiroaki Tsurumaki², Yasuhiko Koga², Takeo Horie¹, Atsushi Takise¹, Takeshi Hisada³

Affiliations

¹ Department of Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Japan.
² Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan.
³ Gunma University Graduate School of Health Sciences, Maebashi, Japan.

Abstract

Background: Although the association between nontuberculous mycobacterial lung disease (NTM-LD) and malnutrition is known, there are a few reports on the association between the nutritional score and death in patients with NTM-LD. This study investigated the association between the nutrition data at the time of NTM-LD diagnosis and death.

Methods: A retrospective study was conducted for patients with NTM-LD who visited the Maebashi Red Cross Hospital from January 2014 to December 2018. The patients were divided into the survival and death groups and analyzed statistically.

Results: The diagnostic criteria for NTM-LD were met by 150 patients. The median age was 70 years (range, 20-94 years). There were 51 (34.0%) men and 99 (66.0%) women. In the death group, the body mass index was significantly low, and there were significantly more patients with asthma. Further, computed tomography at the first visit revealed significantly fewer cases of the nodular bronchiectasis type. In the hematologic examination at the time of NTM-LD diagnosis, the white blood cell, neutrophil, and platelet counts and C-reactive protein and serum calcium levels were significantly higher in the death group, while the serum albumin level was significantly lower. In the death group, the prognostic nutritional index (PNI), calculated from the hematologic findings, was significantly lower, while the Glasgow Prognostic Score (GPS) was significantly higher. A logistic regression analysis was performed on items with significant differences, and the PNI and platelet count were independent factors predicting death.

Conclusions: PNI might be effective as a prognostic factor for NTM-LD.

Keywords: Glasgow Prognostic Score (GPS); mortality; nontuberculous mycobacterial lung disease (NTM-LD); nutrition; prognostic nutritional index (PNI).