Pulmonary exacerbations are associated with subsequent FEV1 decline in both adults and children with cystic fibrosis
| Autor: | Don B. Sanders, Christopher H. Goss, Rachel C. L. Bittner, Margaret Rosenfeld, Gregory J. Redding |
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| Rok vydání: | 2010 |
| Předmět: |
Pulmonary and Respiratory Medicine
Spirometry medicine.medical_specialty Lung medicine.diagnostic_test business.industry Respiratory disease Retrospective cohort study medicine.disease Cystic fibrosis Pulmonary function testing medicine.anatomical_structure Internal medicine Pediatrics Perinatology and Child Health medicine Young adult Intensive care medicine business Cohort study |
| Zdroj: | Pediatric Pulmonology. 46:393-400 |
| ISSN: | 8755-6863 |
| DOI: | 10.1002/ppul.21374 |
| Popis: | Summary. Background: Patients with cystic fibrosis (CF) frequently experience pulmonary exacerbations that may lead to a faster subsequent decline in pulmonary function; however, this relationship has not been clearly established. The purpose of this study was to determine the association between the frequency of pulmonary exacerbations and subsequent forced expiratory volume in 1 sec (FEV1) decline in adults and children with CF. Methods: Cohort study of subjects followed in the Cystic Fibrosis Foundation Patient Registry from 2003 through 2006. Mixed effects modeling was used to estimate differences in rates of decline in FEV1 in 2004‐2006 for patients with 0, 1, 2, or 3þ pulmonary exacerbation(s) in 2003. Results: Of 8,490 subjects who met inclusion criteria, 60% had 0 exacerbations, 23% had 1, 10% had 2, and 7% had 3þ exacerbations in 2003. Compared to children with no pulmonary exacerbations in 2003, children with one or more exacerbations experienced a significantly (P < 0.001) greater rate of FEV1 decline in 2004‐2006. In contrast, among adults, only those with 3þ exacerbations in 2003 had a significantly (P ¼ 0.01) greater rate of FEV1 decline in 2004‐2006 than those with no exacerbations in 2003. Conclusions: There is a strong association between the frequency of pulmonary exacerbations and subsequent decline in pulmonary function. In adults, having 3þ exacerbations, and among children, having any exacerbations is associated with a greater rate of decline in the ensuing 3 years. Improved prevention, identification, and treatment of pulmonary exacerbations are likely to have long-term benefits for patients with CF, especially children. Pediatr |
| Databáze: | OpenAIRE |
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