Risk factors and secondary care utilisation in a primary care population with nontuberculous mycobacterial disease in the UK

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Title: Risk factors and secondary care utilisation in a primary care population with nontuberculous mycobacterial disease in the UK
Author(s): Axson, E
Bual, N
Bloom, C
Quint, J
Item Type: Journal Article
Abstract: Prior research has identified risk factors associated with developing non-tuberculous mycobacterial disease (NTMD); we identified risk factors and secondary care utilisation of NTMD patients in the UK. This was a matched case-control study using electronic healthcare records from Clinical Practice Research Datalink from 2006 to 2016. NTMD was defined using prescription data and Read codes, based on international guidelines. Risk factors for NTMD were investigated using conditional logistic regression within a representative general population. All-cause secondary care utilisation (combined inpatient, outpatient, emergency visits) was investigated for participants with linked Hospital Episode Statistics (HES), using incidence rate ratio (IRR) from 2007 to 2015. We identified 1225 individuals with NTMD. A subset of individuals (426 patients) were eligible for linkage with HES. In the adjusted model, risk factors most strongly associated with an increased likelihood of NTMD included previous tuberculosis (OR 69.0; 47.7–99.8); bronchiectasis (OR 23.3; 12.4–43.9); lung cancer (OR 14.9; 3.98–55.7); oral corticosteroids (OCS; OR 7.28; 4.94–10.7); immunosuppressive (excluding corticosteroids) medication (OR 3.05; 1.15–8.10); being underweight (odds ratio (OR) 2.92; 95% CI 1.95, 4.36); and rheumatoid arthritis (OR 2.12; 1.05–4.27). NTMD patients had significantly higher rates of all-cause secondary care utilisation than non-NTMD patients (IRR 5.80; 5.14–6.46). Using a representative adult population, we identified prior TB, bronchiectasis, lung cancer, immunosuppressive medication, and OCS as the risk factors associated with the highest odds of developing NTMD in the UK. Patients with NTMD experienced nearly six times more all-cause secondary care events following their NTMD diagnosis than patients without NTMD.
Publication Date: 1-Jan-2019
Date of Acceptance: 8-Oct-2018
URI: http://hdl.handle.net/10044/1/65314
DOI: https://dx.doi.org/10.1007/s10096-018-3402-8
ISSN: 0934-9723
Publisher: Springer Verlag
Start Page: 117
End Page: 124
Journal / Book Title: European Journal of Clinical Microbiology and Infectious Diseases
Volume: 38
Issue: 1
Sponsor/Funder: Insmed Limited
Funder's Grant Number: n/a
Copyright Statement: © The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Microbiology
Epidemiology
Risk factors
NTM
COPD
Bronchiectasis
INFECTIONS
BRONCHIECTASIS
Bronchiectasis
COPD
Epidemiology
NTM
Risk factors
06 Biological Sciences
11 Medical And Health Sciences
Microbiology
Publication Status: Published
Online Publication Date: 2018-10-27
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine



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