Prevalence of Nontuberculous Mycobacterial Lung Disease in US Medicare Beneficiaries
Prevalence of Nontuberculous Mycobacterial Lung Disease in US Medicare Beneficiaries
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DOI：
10.1164/rccm.201111-2016oc
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发表时间：
2012-04-15
影响因子：
24.7
通讯作者：
Prevots, D. Rebecca
中科院分区：
文献类型：
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作者：
Adjemian, Jennifer;Olivier, Kenneth N.;Prevots, D. Rebecca
理论基础：肺非结核分枝杆菌(PNTM)是美国老年人发病率的重要原因，但全国范围内的患病率估计缺乏。目的：描述美国65岁或以上成年人中PNTM疾病的流行情况和趋势。方法：对1997-2007年间具有全国代表性的5%的联邦医疗保险B部分受益人进行分析。编制了人口统计和医疗索赔数据，计算了PNTM和选定的合并症的患病率估计值，并评估了随时间的趋势。用Logistic回归分析与PNTM相关的人口学和地理因素。测量和主要结果：从1997年到2007年，PNTM的年患病率从20例/10万人显著增加到47例/10万人，或每年8.2%。这一时期的流行率为112例/10万人，尽管亚洲人/太平洋岛民的流行率是白人的两倍(228例/100,000人比116例/100,000人)。西部各州的期间流行率最高，为149例/10万人，夏威夷的流行率最高，为396例/10万人，其次是东南部各州，期间流行率为131例/10万人。PNTM患者的合并症比非患者多，死亡的可能性比非患者高40%。女性患PNTM的可能性是男性的1.4倍。与白人相比，亚洲人/太平洋岛民患PNTM的可能性是白人的两倍，而黑人的可能性是白人的一半。结论：PNTM在美国所有地区以及男性和女性中的患病率都在上升。显著的种族/民族和地理差异表明了重要的基因-环境相互作用。
Rationale: Pulmonary nontuberculous mycobacteria (PNTM) are an important cause of morbidity among older adults in the United States, but national prevalence estimates are lacking.Objectives: To describe the prevalence and trends of PNTM disease among adults aged 65 years or older throughout the United States.Methods: A nationally representative 5% sample of Medicare Part B beneficiaries was analyzed from 1997 to 2007. Demographic and medical claims data were compiled and prevalence estimates for PNTM and selected comorbidities were calculated and trends over time evaluated. Logistic regression was used to identify demographic and geographic factors associated with PNTM.Measurements and Main Results: From 1997 to 2007, the annual prevalence significantly increased from 20 to 47 cases/100,000 persons, or 8.2% per year. The period prevalence was 112 cases/100,000 persons, although prevalence was twofold higher among Asians/Pacific Islanders than among whites (228 vs. 116 cases/100,000 persons). Western states had the highest period prevalence at 149 cases/100,000 persons, with Hawaii having the highest prevalence at 396 cases/100,000 persons, followed by southeastern states, which had a period prevalence of 131 cases/100,000 persons. PNTM cases had more comorbid conditions than noncases and were 40% more likely to die than noncases. Women were 1.4 times more likely to be a PNTM case than men. Relative to whites, Asians/Pacific Islanders were twice as likely to be a case, whereas blacks were half as likely.Conclusions: The prevalence of PNTM is increasing across all regions of the United States and among both men and women. Significant racial/ethnic and geographic differences suggest important gene-environment interactions.