Hospitalization Risk for Medicare Beneficiaries With Nontuberculous Mycobacterial Pulmonary Disease
| Autor: | Theodore K. Marras, Kevin C. Mange, Patrick A. Flume, D. Rebecca Prevots, Ping Wang |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Lung Diseases
Male Risk Pulmonary and Respiratory Medicine medicine.medical_specialty Multivariate analysis ICD-10-CM International Classification of Diseases Tenth Revision Clinical Modification Mycobacterium Infections Nontuberculous IRR incidence rate ratio Pulmonary disease Comorbidity US Medicare Medicare Critical Care and Intensive Care Medicine Rate ratio ICD-9-CM International Classification of Diseases Ninth Revision Clinical Modification Internal medicine medicine Humans Lung function Aged Retrospective Studies COPD Bronchiectasis CCI Charlson Comorbidity Index biology business.industry Medicare beneficiary NTM nontuberculous mycobacteria bacterial infections and mycoses medicine.disease biology.organism_classification United States Hospitalization Case-Control Studies nontuberculous mycobacterial pulmonary disease Female Nontuberculous mycobacteria NTM-PD nontuberculous mycobacterial pulmonary disease Chest Infections: Original Research Cardiology and Cardiovascular Medicine business |
| Zdroj: | Chest |
| ISSN: | 0012-3692 |
| Popis: | Background Nontuberculous mycobacterial pulmonary disease (NTM-PD) is an uncommon mycobacterial infection characterized by worsening lung function and increased health care resource utilization; however, the overall risk for hospitalization among patients with NTM-PD remains unclear. Research Question What is the hospitalization risk among older adults with NTM-PD? Study Design and Methods A retrospective, nested, case-control study was conducted by using the Medicare claims database. Cases were defined as patients with ≥ 2 NTM-PD claims ≥ 30 days apart between January 1, 2007, and December 31, 2015. The study included individuals aged ≥ 65 years with ≥ 12 months of continuous enrollment in both Parts A and B before the first NTM-PD diagnosis. Cases were matched 1:2 to Medicare beneficiaries without NTM-PD (control subjects) according to age and sex. Hospitalizations following the first NTM-PD claim were compared between case and control subjects by using univariate and multivariate analyses. Results A total of 35,444 case subjects and 65,467 matched control subjects (mean age, 76.6 years; 70% female; ≥ 87% White) were identified. Baseline comorbidities, particularly pulmonary comorbidities, were more common in case subjects than in control subjects (81.1% vs 17.7% for COPD; 44.6% vs 0.6% for bronchiectasis). All-cause hospitalization was observed in 65.7% of case subjects and 44.9% of control subjects. Unadjusted annual hospitalization rates were significantly (P < .05) greater among case subjects than control subjects. Case subjects also had a significantly shorter time to hospitalization than control subjects. The increased burden due to hospitalization was reflected in multivariate analysis adjusting for baseline comorbidities. All-cause hospitalization in patients with NTM-PD relative to control subjects was 1.2 times more likely (relative risk, 1.23; 95% CI, 1.21-1.25; P < .0001) with a 46% greater hazard (hazard ratio, 1.46; 95% CI, 1.43-1.50; P < .0001). Interpretation Patients with NTM-PD were significantly more likely to be hospitalized, had greater annualized hospitalization rates, and had shorter time to hospitalization than age- and sex-matched control subjects without NTM-PD. These findings highlight the significantly increased burden of hospitalizations among patients with NTM-PD. Graphical Abstract |
| Databáze: | OpenAIRE |
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