Probability of Treatment Following Acute Decline in Lung Function in Children with Cystic Fibrosis is Related to Baseline Pulmonary Function

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• 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

文摘

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Objective

To determine whether the association between high forced expiratory volume in 1 second (FEV₁) and increased rate of decline in FEV₁ in children with cystic fibrosis could be due to less frequent intervention after acute declines (sudden decline events) in FEV₁.

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 FEV₁ % 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 FEV₁ % 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.

Results

A total of 10 888 patients had at least 1 sudden decline event in FEV₁. Patients in the highest FEV₁ 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.

Conclusions

Children and adolescents with high baseline lung function are less likely to receive a therapeutic intervention following an acute decline in FEV₁, which may explain their greater rate of FEV₁ decline.