Predictors of mortality in adults with cystic fibrosis

Pediatric Pulmonology - Tập 42 Số 6 - Trang 525-532 - 2007
Jo‐Maree Courtney1, Judy Bradley1,2, John McCaughan3, Terence M. O’Connor4, C. Shortt4, C. P. Bredin4, Ian Bradbury5, J.S. Elborn1
1Adult Cystic Fibrosis Unit, Belfast City Hospital, Belfast, Northern Ireland, Ireland.
2Health and Rehabilitation Sciences Research Institute, University of Ulster, Belfast, Ireland
3Department of Microbiology, Queens University, Belfast, Ireland
4Adult Cystic Fibrosis Unit, Cork University Hospital, Cork, Ireland
5Department of Medical Statistics, University of Ulster, Belfast, Ireland

Tóm tắt

AbstractAssessment of prognostic indicators in patients with cystic fibrosis (CF) is important. The study's aim was to assess the relative contribution of gender, genetics and microbiology on survival in adults with CF. Adult patients were studied from 1995 to 2005 and data collected included FEV1 (%predicted), body mass index (BMI), genetics, and microbiology. Data was available on 183 patients in 1995. Forty‐five patients died in the subsequent 10 years. Patients who died during the study had lower mean (SD) FEV1 %predicted in 1995 when compared to those remaining alive, 41.5 (15.2)% versus 69.8 (23.2)% predicted, respectively, P < 0.001 and they had lower mean (SD) BMI in 1995, 19.2 (3.3) kg/m2 in comparison to those remaining alive, 20.7 (3.4) kg/m2, P = 0.008. The proportion of patients infected with Pseudomonas aeruginosa and Burkholderia cepacia complex was higher in the group who died during the study compared to those remaining alive, odds ratio 20.9 P < 0.0001 and 7.1 P < 0.0001, respectively. The presence of the ΔF508 homozygous mutation did not alter survival, P = 0.3. Patients infected with either P.aeruginosa or B.cepacia complex had reduced survival compared to those without infection, P = 0.01 and P < 0.0001, respectively. FEV1% (P < 0.0001), infection with P.aeruginosa (P = 0.005) or B.cepacia complex (P = 0.03) were the only significant predictors of mortality. This study demonstrates adults who died were more likely to have worse lung function and be infected with either P.aeruginosa or B.cepacia complex. FEV1% and infection with P.aeruginosa or B.cepacia complex were the most significant predictors of survival in adults with CF. Pediatr Pulmonol. 2007; 42:525–532. © 2007 Wiley‐Liss, Inc.

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Pediatric Pulmonology

Tập 42 Số 6

525-532

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