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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 BMC+Infect+Dis 2018 ; 18 (ä): ä Nephropedia Template TP
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High mortality in patients with Mycobacterium avium complex lung disease: a systematic review #MMPMID29724184
Diel R; Lipman M; Hoefsloot W
BMC Infect Dis 2018[]; 18 (ä): ä PMID29724184show ga
Background: The incidence of nontuberculous mycobacterial (NTM) pulmonary disease caused by Mycobacterium avium complex (MAC) in apparently immune-competent people is increasing worldwide. We performed a systematic review of the published literature on five-year all-cause mortality in patients with MAC lung disease, and pooled the mortality rates to give an overall estimate of five-year mortality from these studies. Methods: We systematically reviewed the literature up to 1st August 2017 using PubMedŽ and ProQuest Dialog? to search MedlineŽ and EmbaseŽ databases, respectively. Eligible studies contained >?10 patients with MAC, and numerical five-year mortality data or a treatment evaluation for this patient group. Mortality data were extracted and analysed to determine a pooled estimate of all-cause mortality. Results: Fourteen of 1035 identified studies, comprising 17 data sets with data from a total of 9035 patients, were eligible. The pooled estimate of five-year all-cause mortality was 27% (95% CI 21.3?37.8%). A high degree of heterogeneity was observed (I2 =?96%). The mortality in the data sets varied between 10 and 48%. Studies predominantly including patients with cavitary disease or greater comorbidity reported a higher risk of death. Patients in Asian studies tended to have a lower mortality risk. Predictors of mortality consistent across studies included male sex, presence of comorbidities and advanced patient age. Conclusions: Despite high heterogeneity, most studies in patients with MAC pulmonary disease document a five-year all-cause mortality exceeding 25%, indicating poor prognosis. These findings emphasise the need for more effective management and additional prospective mortality data collection. Electronic supplementary material: The online version of this article (10.1186/s12879-018-3113-x) contains supplementary material, which is available to authorized users.