Tuberculosis and Respiratory Diseases最新文献

{"title":"Korean Clinical Practice Guidelines for Interstitial Lung Disease: Part 2. Idiopathic Pulmonary Fibrosis.","authors":"Hye Sook Choi, Hee-Young Yoon, So Young Park, Jongmin Lee, Ji Young Kang, Jun Yeun Cho, Sung Soo Jung, Won Il Choi","doi":"10.4046/trd.2026.0097","DOIUrl":"10.4046/trd.2026.0097","url":null,"abstract":"<p><p>Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial pneumonia marked by declining lung function, severe dyspnea, and a poor prognosis. Antifibrotic agents have improved outcomes in patients with IPF, but diagnosing the disease, monitoring its course, and managing it over the long term remain challenging. Since the publication of the first Korean clinical practice guideline for interstitial lung disease in 2018, research has advanced substantially and has reshaped the clinical management of IPF. This updated guideline draws on evidence published over the past 5 years and covers the epidemiology, pathogenesis, risk factors, clinical manifestations, diagnosis, treatment, comorbidities, prognosis, and acute exacerbations of IPF. Expert consensus was also used to formulate key clinical questions, and systematic reviews and meta-analyses were then performed to reassess how antifibrotic agents affect lung function decline, mortality, and acute exacerbations in patients with IPF. This guideline aims to standardize the clinical management of IPF, improve diagnostic accuracy, and encourage the appropriate use of available treatments. It is intended for physicians, other healthcare professionals who care for patients with IPF, and healthcare policymakers in Korea.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"435-452"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home High-Flow Nasal Cannula Oxygen Therapy in a Chronic Obstructive Pulmonary Disease Patient with Chronic Stable Hypoxemic and Hypercapnic Respiratory Failure.","authors":"Young Jae Kim, Sang Bong Choi, Ju Hyun Oh, Hyuk Pyo Lee, Youjin Chang","doi":"10.4046/trd.2026.0087","DOIUrl":"10.4046/trd.2026.0087","url":null,"abstract":"","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"564-567"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide Incidence and Prevalence of Idiopathic Pulmonary Fibrosis in South Korea.","authors":"Hee-Young Yoon, Kyung Hoon Kim, Song Yee Kim, Moo Suk Park, Jong Sun Park, Joo Hun Park, Soo Taek Uh, Jung-Wan Yoo, Jin Hwa Lee, Won-Il Choi, Jae Ha Lee, Chang Hoon Han","doi":"10.4046/trd.2026.0012","DOIUrl":"10.4046/trd.2026.0012","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease with high mortality. Population-based data on long-term epidemiological trends and real-world treatment outcomes in Asia remain limited. This study described national trends in IPF prevalence and incidence in South Korea and evaluated pirfenidone use and associated mortality.</p><p><strong>Methods: </strong>Using the Korean National Health Insurance Service customized research database, we identified prevalent IPF cases from 2010 to 2023 and incident cases from 2011 to 2023. IPF was defined using the International Classification of Diseases, 10th Revision, and rare intractable disease codes, based on a predefined operational definition. Among incident cases, the association between pirfenidone use and all-cause mortality was assessed using multivariable-adjusted Cox proportional hazards models.</p><p><strong>Results: </strong>A total of 91,638 prevalent and 28,683 incident IPF cases were identified during the study period. The crude prevalence increased from 8.91 per 100,000 persons ≥50 years in 2010 to 63.78 per 100,000 in 2023. The crude incidence increased from 6.07 per 100,000 in 2011 to 16.86 per 100,000 in 2023. Similar increasing patterns were observed for age- and sex-standardized rates. IPF was more common in men, and demonstrated a pronounced age gradient. Following reimbursement approval, pirfenidone use increased substantially. Pirfenidone use was associated with a reduced risk of all-cause mortality (adjusted hazard ratio, 0.627; 95% confidence interval, 0.600 to 0.655), with progressively stronger associations observed with longer treatment duration.</p><p><strong>Conclusion: </strong>The burden of IPF in South Korea has increased over the past decade, during which expanded real-world pirfenidone use was associated with improved survival.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"517-528"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visualizing Three Decades of Chronic Obstructive Pulmonary Disease and Airway Mucus Hypersecretion Research: A Bibliometric Analysis (1994-2024).","authors":"Naer An, Dongmei Wang, Dan Xu, Jiangyue Qin, Yanqiu Wu, Lijuan Gao, Fangying Chen, Zhenni Chen, Lian Liu, Yongchun Shen, Fuqiang Wen","doi":"10.4046/trd.2025.0199","DOIUrl":"10.4046/trd.2025.0199","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a condition with high prevalence and mortality, causing a substantial disease burden. Airway mucus hypersecretion (AMH) is clinically associated with impaired pulmonary function, diminished quality of life, and increased mortality in COPD patients. The purpose of this bibliometric research was to identify research developments and emerging hotspots within the field of AMH and COPD by providing a comprehensive overview of the current research landscape.</p><p><strong>Methods: </strong>The Web of Science core database was searched for publications addressing COPD and AMH from January 1, 1994, to December 31, 2024. A total of 1,405 publications were retrieved and subjected to bibliometric and visual analyses using CiteSpace, VOSviewer, and R software.</p><p><strong>Results: </strong>From 1994 to 2024, both publication output and citation frequency in this field demonstrated a sustained upward trajectory. The United States of America occupies a prominent position in this domain, characterized by substantial collaborative networks and research productivity. While extensive inter-country and interinstitutional collaborations were evident, researcher-level collaborations remained relatively fragmented. Notably, Boucher, Richard C. received substantial recognition owing to his exceptional research productivity and citation impact. Keywords including exacerbations, autophagy, and mucus plugs exhibited the strongest citation bursts during 2023-2024.</p><p><strong>Conclusion: </strong>This research illustrates the present landscape, focal points, and future directions in the fields of COPD and AMH. Researchers may benefit from obtaining a rapid synopsis, along with citations and innovative concepts, to facilitate and inform subsequent investigations.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"491-505"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Safety of Fluticasone Furoate/Umeclidinium/Vilanterol in Patients with Asthma or Chronic Obstructive Pulmonary Disease (COPD), and Clinical Outcomes in COPD: Post-marketing Surveillance in Korea.","authors":"Eun-Bin Lee, Jung-Eun Cho, Eunsun Kwon, Karam Ko, Sang Heon Kim, Sang-Ha Kim","doi":"10.4046/trd.2025.0158","DOIUrl":"10.4046/trd.2025.0158","url":null,"abstract":"<p><strong>Background: </strong>Fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) is a single-inhaler triple therapy administered via the ELLIPTA inhaler (GSK). FF/UMEC/VI 100/62.5/25 μg was approved in Korea to treat chronic obstructive pulmonary disease (COPD) in 2018 and asthma in 2022 (100/62.5/25 and 200/62.5/25 μg). Safety and efficacy of FF/UMEC/VI are well established in global clinical trials, though Korean real-world evidence remains limited.</p><p><strong>Methods: </strong>This Korean multicentre post-marketing surveillance assessed safety and clinical outcomes of FF/UMEC/VI 100/62.5/25 μg in COPD (May 2018-May 2024) and safety of FF/UMEC/VI in asthma (100/62.5/25 μg: August 2022-May 2024; 200/62.5/25 μg: September 2022-May 2024). Safety was assessed by total, serious, and unexpected adverse event and adverse drug reaction (ADR) incidence. For COPD, physicians assessed within-patient improvement in clinical outcomes (lung function [forced expiratory volume in 1 second, forced vital capacity], exacerbations and symptoms [modified Medical Research Council dyspnoea, COPD Assessment Test]).</p><p><strong>Results: </strong>Overall, 606 patients with COPD and 132 patients with asthma were evaluated. Mean±standard deviation administration for FF/UMEC/VI 100/62.5/25 μg was 254.11±119.97 days overall; 271.83±104.99 for COPD; 20.74±10.87 for integrated asthma; 34.17±13.06 days for asthma with FF/UMEC/VI 200/62.5/25 μg. ADRs occurred in 2.64% (16/606) of patients with COPD and 3.79% (5/132) with asthma. Most ADRs were mild; all serious/unexpected ADRs resolved. Of 33 patients with COPD who reported pneumonia, all events were considered unlikely to be treatment-related. Physicians determined improvement in 74.87% (283/378) of patients with COPD post- versus pre-FF/UMEC/VI administration.</p><p><strong>Conclusion: </strong>FF/UMEC/VI was well tolerated in Korean patients with asthma or COPD, with no new safety concerns identified. In COPD, within-patient improvement was observed in clinical outcomes post-administration. These results support continued FF/UMEC/VI use in real-world clinical practice in Korea.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"464-479"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Epidemiology of Severe Pneumococcal Pneumonia in Adults at a Tertiary Hospital between 2010 and 2024.","authors":"Sang-Ho Choi, Jin Won Huh, Sang-Bum Hong, Heungsup Sung, Kyung-Hyun Do, Sang-Oh Lee, Chae-Man Lim, Younsuck Koh","doi":"10.4046/trd.2026.0003","DOIUrl":"10.4046/trd.2026.0003","url":null,"abstract":"<p><strong>Background: </strong>The epidemiology of pneumococcal pneumonia can be influenced by vaccine implementation, serotype replacement, and viral circulation. We aimed to investigate 15-year trends in the epidemiological and clinical characteristics of severe pneumococcal pneumonia patients requiring intensive care unit (ICU) admission.</p><p><strong>Methods: </strong>We analyzed data from a prospective cohort of adult patients with severe pneumonia admitted to the 28-bed medical ICU of a 2,700-bed tertiary hospital in South Korea between 2010 and 2024. Temporal changes in incidence, resistance to antimicrobial agents, frequency of coinfections, and mortality were evaluated across three 5-year periods.</p><p><strong>Results: </strong>Among 2,511 ICU patients with severe pneumonia, 140 (5.6%) had pneumococcal infections. The proportion of pneumococcal cases decreased from 9.9% in 2010-2014 to 4.2% in 2015-2019, and further to 2.2% in 2020-2024 (p<0.001 for trend). Conversely, ceftriaxone non-susceptibility rates rose sharply from 4.8% to 16.7% and 45.5% across the same periods (p<0.001). Coinfections were frequent and increased significantly, largely due to respiratory viruses, with rates of 48.9%, 61.8%, and 77.8%, respectively (p=0.02). Influenza was the predominant co-pathogen during 2015-2019, whereas severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was most frequent in 2020-2024. The 90-day mortality rates remained stable over time (29.5%, 38.2%, and 27.8%, p=0.64).</p><p><strong>Conclusion: </strong>In this single-center ICU cohort, the proportion of severe pneumococcal pneumonia cases decreased over the 15-year period, whereas ceftriaxone non-susceptibility and viral coinfections became more frequent. These trends should be interpreted cautiously given the lack of serotype and individual vaccination data and incomplete susceptibility results. Continued surveillance of pneumococcal disease, antimicrobial resistance, and respiratory coinfections is warranted.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"553-563"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multicenter Registry for Rare Interstitial Lung Diseases in Korea: Baseline Characteristics and Clinical Outcomes.","authors":"Ju Hyun Oh, Jae Ha Lee, Sung Woo Park, Yong Suk Jo, Jong Sun Park, Hongseok Yoo, Kyung Hoon Kim, Yangin Jegal, Joo Hun Park, Jinkyeong Park, Taehun Kim, Bo-Guen Kim, Hyung Koo Kang, Hyun-Kyung Lee, Ji Young Kang, Hee-Young Yoon, Hye Ju Yeo, Dong Won Park, Ala Woo, Jung-Wan Yoo, Jin Woo Song","doi":"10.4046/trd.2026.0004","DOIUrl":"10.4046/trd.2026.0004","url":null,"abstract":"<p><strong>Background: </strong>Rare interstitial lung diseases (ILDs) are a heterogeneous group of diffuse parenchymal lung disorders with low prevalence and diverse etiologies that pose diagnostic and therapeutic challenges. We aimed to establish a nationwide, multicenter registry of rare ILDs in South Korea to characterize their clinical features and outcomes.</p><p><strong>Methods: </strong>We conducted a multicenter, observational cohort study involving 304 patients with rare ILDs including Birt-Hogg-Dubé syndrome (BHD), lymphangioleiomyomatosis (LAM), pulmonary alveolar proteinosis (PAP), pulmonary Langerhans cell histiocytosis (PLCH), pleuroparenchymal fibroelastosis (PPFE), and hypersensitivity pneumonitis (HP) enrolled across 20 centers in Korea between September 2023 and December 2024. Data on clinical characteristics, outcomes, and treatment were collected.</p><p><strong>Results: </strong>LAM (28.3%) and PAP (26.6%) were the most prevalent, followed by BHD (18.1%), PLCH (13.2%), HP (7.6%), and PPFE (6.3%). Dyspnea was common in HP and PPFE, whereas BHD and LAM were often asymptomatic. Pneumothorax was frequent in BHD (44.6%) and LAM (11.6%) at diagnosis. PPFE showed the most impaired lung function and the highest mortality (26.3%), during a median follow-up of 69.5 months, followed by PAP (6.2%) and BHD (1.8%). During follow-up, cancer was reported in 25.5% of patients with BHD. Treatment strategies varied by disease: corticosteroids were commonly used in HP (86.9%), PPFE (42.1%), and PLCH (32.5%); sirolimus in LAM (53.5%); pirfenidone in PPFE (42.1%); and whole-lung lavage in PAP (23.5%).</p><p><strong>Conclusion: </strong>This is the first nationwide rare ILD registry in Korea, demonstrating heterogeneity in clinical features and outcomes and emphasizing the need for disease-specific diagnostic and therapeutic strategies.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"529-541"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Anticoagulants as a Supportive Measure in Pulmonary Hypertension: A Narrative Review.","authors":"Olena Les, Tigran Aghabekyan, Dedipya Bhamidipati, Pooja Belligund, Patrick Geraghty, Varshitha Panduranga, Samy McFarlane, Sabu John","doi":"10.4046/trd.2026.0047","DOIUrl":"10.4046/trd.2026.0047","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) is a heterogeneous disorder with substantial morbidity and mortality. Thrombotic remodeling of pulmonary vasculature is a recognized contributor to disease progression, particularly in pulmonary arterial hypertension (PAH), prompting interest in anticoagulation as a potential adjunctive therapy. Despite the frequent use, anticoagulants continue to remain a controversial therapy across various subtypes of PH.</p><p><strong>Methods: </strong>This review structurally evaluated published studies and evidence around the risks and benefits of anticoagulation across all five PH groups. Relevant peer-reviewed clinical trials, observational studies, and meta-analyses were identified through searches of PubMed, the Cochrane Library, and Google Scholar and were reviewed for survival outcomes, thromboembolic events, hemodynamics, and bleeding complications associated with anticoagulant use in PH.</p><p><strong>Results: </strong>Evidence suggests that anticoagulation may provide a survival benefit in idiopathic PAH, while outcomes in connective tissue disease-associated PAH appear neutral or unfavorable due to increased bleeding risk. In other PH groups, anticoagulation has not demonstrated clear benefit and is generally reserved for standard indications such as atrial fibrillation or venous thromboembolism, except in chronic thromboembolic PH, where it remains a cornerstone of therapy.</p><p><strong>Conclusion: </strong>There is currently no clear consensus on anticoagulation strategies across most PH subtypes (except group 4). Given the heterogeneity of PH, further well-designed prospective trials and PH-specific risk stratification tools are needed to clarify the role of anticoagulation and advance precision-based care in PH.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"453-463"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Eosinophil Count, Disease Severity, and Exacerbation Risk in Korean Patients with Bronchiectasis: A Retrospective Cohort Study.","authors":"Sun-Hyung Kim, Dong Eun Kye, Geun-Hyeong Kim, Jiyoul Yang, Jun Yeun Cho, Ki Man Lee, Seung Park, Eun Jin Kwon, Kyung Sik Yi, Hyun Lee, Bumhee Yang","doi":"10.4046/trd.2025.0219","DOIUrl":"10.4046/trd.2025.0219","url":null,"abstract":"<p><strong>Background: </strong>Peripheral blood eosinophil counts have been associated with bronchiectasis outcomes, but findings remain inconsistent, and their role in acute exacerbations among Korean patients is unclear.</p><p><strong>Methods: </strong>This study retrospectively evaluated 491 patients with bronchiectasis at a tertiary hospital in Korea between 2014 and 2021. Using a negative binomial regression model adjusted for follow-up duration, we evaluated the association between peripheral eosinophil counts and acute exacerbations in Korean patients with bronchiectasis.</p><p><strong>Results: </strong>Among the 491 patients, 190 (38.7%) were categorized into the lower eosinophilic group, 221 (45.0%) into the normal eosinophilic group, and 80 (16.3%) into the higher eosinophilic group. No significant differences were observed across eosinophilic groups in terms of hospitalization within 1 year, bronchiectasis severity index scores, or forced expiratory volume in 1 second (F), age (A), presence of chronic colonization by Pseudomonas aeruginosa (C), radiological extension (number of pulmonary lobes affected) (E), dyspnea (D) (FACED) scores (all p>0.05). In the parsimonious negative binomial regression analysis with false discovery rate (FDR) correction, oral corticosteroid use (incidence rate ratio [IRR], 2.26; 95% confidence interval [CI], 1.46 to 3.52; FDR p=0.001), older age (IRR, 1.03; 95% CI, 1.01 to 1.04; FDR p=0.002), and lower forced expiratory volume in 1 second (FEV1) % predicted (IRR, 0.98; 95% CI, 0.97 to 0.99; FDR p<0.001) were identified as independent risk factors for acute exacerbations.</p><p><strong>Conclusion: </strong>There was no significant association between peripheral blood eosinophil counts and either acute exacerbations or disease severity in Korean patients with bronchiectasis. In contrast, older age, lower lung function (FEV1 % predicted), and the use of oral corticosteroids were identified as independent risk factors for acute exacerbations. These findings underscore the importance of considering region-specific clinical and epidemiological factors in the management of bronchiectasis.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"480-490"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Screening Model for Exercise-Induced Desaturation by Machine Learning Method.","authors":"Seung Ju Kim, Jae Ha Lee, Ji-Yong Moon, Chang Youl Lee, Soo-Jung Um, Seong Yong Lim, Hyoung Kyu Yoon, Kwang Ha Yoo, Chin Kook Rhee, Won-Yeon Lee","doi":"10.4046/trd.2026.0041","DOIUrl":"10.4046/trd.2026.0041","url":null,"abstract":"<p><strong>Background: </strong>Exercise-induced desaturation (EID) during the 6-minute walk test (6MWT) is an established marker of adverse outcomes in patients with chronic obstructive pulmonary disease (COPD). Therefore, we aimed to develop a machine learning approach focused on screening to identify patients at increased risk of EID.</p><p><strong>Methods: </strong>We analyzed data from the nationwide, multicenter Korea COPD Subgroup Study. EID was defined as a peripheral oxygen saturation (SpO2) <90% with a decrease of ≥4%p. The cohort was divided into training (80%) and test (20%) sets. Candidate predictors were selected using the Boruta algorithm, and models were developed using multivariable logistic regression, extreme gradient boosting (XGB), random forest, and support vector classification, employing a screening-oriented threshold strategy that prioritized sensitivity.</p><p><strong>Results: </strong>Among 1,788 patients with COPD, 185 (10.3%) exhibited EID. All models demonstrated a high precision-recall area under the curve (PR-AUC) during internal validation. The predictors selected by the Boruta algorithm included body mass index, COPD Assessment Test, St. George's Respiratory Questionnaire for COPD patients, mental health indicators, pulmonary function parameters, X-ray-identified bronchiectasis, and hemoglobin level. In the independent test set, PR-AUC decreased across models, while calibration metrics showed modest differences between datasets. The XGB model achieved the highest sensitivity during internal validation, and both its sensitivity and specificity remained relatively stable in the test set. Baseline SpO2 and diffusion capacity of the lung for carbon monoxide were the most influential predictors.</p><p><strong>Conclusion: </strong>A screening-oriented machine learning approach utilizing routinely available variables may facilitate targeted referral for the 6MWT in COPD patients.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"506-516"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}