BACES Score as a Proxy of Health-Related Quality of Life and Associated Factors in Nontuberculous Mycobacterial Pulmonary Disease

Abstract Rationale: Health-related quality of life (HRQOL) is gaining importance among patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). We investigated whether the BACES score reflects HRQOL and associated factors in patients with NTM-PD. Methods: We used data from the nationwide NTM-KOREA prospective cohort of patients with NTM-PD who started antibiotic treatment. HRQOL and associated factors were measured, including symptoms, Quality of Life-Bronchiectasis (QOL-B) questionnaire, nutritional status using the Mini Nutritional Assessment-Short Form (MNA-SF) and prognostic nutritional index (PNI), physical activity, body composition, spirometry, handgrip strength, and 6-min walking distance. Associations between the BACES score and HRQOL and associated factors at enrollment were investigated in multivariate linear and logistic regression analyses. Results: We included 409 patients (median, 64 years; men, 27.6%). As the BACES score increased, the odds (adjusted odds ratio [95% confidence interval]) of cough (1.24 [1.04-1.48]), dyspnea (1.69 [1.28-2.27]), weight loss (1.78 [1.36-2.36]), malnutrition defined as MNA-SF score ≤ 7 (1.71 [1.21-2.45]), and PNI < 45 (2.14 [1.66-2.81]) also increased. The QOL-B respiratory symptom score (estimate −2.259, P=0.002) and 6-min walking distance (estimate −18.015, P<0.001) were negatively associated with the BACES score. Moreover, the odds of adipopenia (1.08 [1.03-1.13]), possible sarcopenia (2.15 [1.35-3.59]), and sarcopenia (2.37 [1.33-4.55]) increased in women, while adipopenia (1.15, [1.05-1.26] was associated with the BACES score in men. Conclusions: The BACES score can serve as a proxy for HRQOL and associated conditions at antimicrobial treatment initiation in patients with NTM-PD.