- 作者：Wayne J. Morgan ; Jeffrey S. Wagener ; Ashley Yegin ; David J. Pasta ; Stefanie J. Millar ; Michael W. Konstan ; Scientific Advisory Group ; investigators ; ; coordinators of the Epidemiologic Study of Cystic Fibrosis
- 关键词：CF ; Cystic fibrosis ; ESCF ; Epidemiologic Study of Cystic Fibrosis ; FEV1 ; Forced expiratory volume in 1 second ; IV ; Intravenous
- 刊名：The Journal of Pediatrics
- 出版年：2013
- 出版时间：October, 2013
- 年：2013
- 卷：163
- 期：4
- 页码：1152-1157.e2
- 全文大小：511 K
ss=""h4"">Objective
To determine whether the association between high forced expiratory volume in 1 second (FEV<sub>1sub>) and increased rate of decline in FEV<sub>1sub> in children with cystic fibrosis could be due to less frequent intervention after acute declines (sudden decline events) in FEV<sub>1sub>.ss=""h4"">Study design
Patients with cystic fibrosis aged 6-17 years enrolled in the Epidemiologic Study of Cystic Fibrosis were assessed for a sudden decline event, defined as a 10 % relative decline in FEV<sub>1sub> % predicted from an average of 3 consecutive stable baseline spirometries. The likelihood of therapeutic intervention within 14 days before and 56 days after this event was then related to their baseline FEV<sub>1sub> % predicted age-specific decile using a logistic regression adjusting for age group (6-12 years, 13-17 years) and presence of Pseudomonas aeruginosa on respiratory culture.
ss=""h4"">Results
A total of 10 888 patients had at least 1 sudden decline event in FEV<sub>1sub>. Patients in the highest FEV<sub>1sub> decile were significantly less likely than those in the lowest decile to receive intravenous antibiotics (OR, 0.14; 95 % CI, 0.11-0.18; P < .001) or be hospitalized (OR, 0.18; 95 % CI, 0.14-0.23; P < .001) following decline.
ss=""h4"">Conclusions
Children and adolescents with high baseline lung function are less likely to receive a therapeutic intervention following an acute decline in FEV<sub>1sub>, which may explain their greater rate of FEV<sub>1sub> decline.