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Variation in lung function is associated with worse clinical outcomes in cystic fibrosis

Authors :
João Paulo Heinzmann-Filho
Leonardo Araujo Pinto
Paulo José Cauduro Marostica
Márcio Vinícius Fagundes Donadio
Source :
Jornal Brasileiro de Pneumologia, Vol 41, Iss 6, Pp 509-515 (2015)
Publication Year :
2015
Publisher :
Sociedade Brasileira de Pneumologia e Tisiologia, 2015.

Abstract

ABSTRACT OBJECTIVE: To determine whether the variation in lung function over one year is associated with worse clinical outcomes, as well as with a decline in lung function in the following years, in patients with cystic fibrosis (CF). METHODS: This was a retrospective study involving CF patients (4-19 years of age), evaluated over a three-year period. We evaluated demographic characteristics, chronic Pseudomonas aeruginosa infection, antibiotic use, hospitalization, six-minute walk distance (6MWD), and lung function. The inclusion criterion was having undergone pulmonary function testing at least three times in the first year and at least once in each of the next two years. RESULTS: We evaluated 35 CF patients. The variation in FEV1 in the first year (FEV1) was greater among those who, in the third year, showed reduced FEV1, had a below-average 6MWD, or were hospitalized than among those with normal FEV1, normal 6MWD, or no hospital admissions, in that same year (p < 0.05), although no such difference was found for antibiotic use in the third year. Subjects showing a FEV1 ≥ 10% also showed a greater decline in FEV1 over the two subsequent years (p = 0.04). The FEV1 also showed an inverse correlation with absolute FEV1 in the third year (r = −0.340, p = 0.04) and with the rate of FEV1 decline (r = −0.52, p = 0.001). Linear regression identified FEV1 as a predictor of FEV1 decline (coefficient of determination, 0.27). CONCLUSIONS: Significant variation in lung function over one year seems to be associated with a higher subsequent rate of FEV1 decline and worse clinical outcomes in CF patients. Short-term FEV1 might prove useful as a predictor of CF progression in clinical practice.

Details

Language :
English, Portuguese
ISSN :
18063756
Volume :
41
Issue :
6
Database :
Directory of Open Access Journals
Journal :
Jornal Brasileiro de Pneumologia
Publication Type :
Academic Journal
Accession number :
edsdoj.4cc460ac85154f1592f3267fdccf777a
Document Type :
article
Full Text :
https://doi.org/10.1590/s1806-37562015000000006