Impaired health-related quality of life in pulmonary nontuberculous mycobacterial disease

Abstract

Introduction: The impact of pulmonary nontuberculous mycobacterial (pNTM) disease on health-related quality of life (HRQL) has not been quantified.

Methods: We performed a prospective observational study of HRQL in 51 patients with pNTM disease. One generic (Short-form 36, version 2 -SF-36), and one pulmonary disease-specific instrument (St. George's Respiratory Questionnaire--SGRQ) were administered to each subject.

Results: Fifty-one patients with pNTM disease from one ambulatory clinic were enrolled. The mean (sd) age was 67 (10) years and 80% (41/51) were female. The most common causative NTM was MAC in 84% (43/51) followed by Mycobacterium abscessus in 8% (4/51). Radiographic disease type was nodular bronchiectasis in 71% (36/51) and fibrocavitary in 22% (11/51). For SF-36, most raw scores were at least 10 points below Canadian population-based normals, and all normbased scores were below the expected normal value of 50. For SGRQ, all scores were worse by ≥ 25 points compared with published normals. In multivariable analyses, only FVC and DLCO were significantly associated with SF-36, and only FVC and emphysema were significantly associated with SGRQ.

Conclusion: Patients with pNTM disease have significantly impaired HRQL that is most closely associated with lung function and not readily explained by age, sex or extra-pulmonary comorbidity.