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P79 The Impact of Social Deprivation on Clinical Outcomes in Children with Cystic Fibrosis (CF) in a Deprived Area of Scotland
  1. J Barge,
  2. Y Cheong,
  3. L Thomson,
  4. NA Gibson,
  5. PL Davies
  1. Royal Hospital for Sick Children, Glasgow, UK

Abstract

Introduction Lung function tests and BMI are widely-used outcome measures in children with CF, and their preservation requires adherence to exacting treatment regimens.

We hypothesised that deprivation might affect the adherence to therapy of children in a deprived area of Scotland, thus reducing BMI and FEV1 scores and increasing clinical input required.

Schechter (2003) demonstrated a link between deprivation and mortality in children with CF, although the mechanism remained unclear, and the study has not been repeated elsewhere. In an adult CF population in an affluent area of England, Jarad (2005) found no correlation between deprivation and FEV1. This question has not previously been examined in a deprived paediatric population.

Method In February 2013, RHSC Glasgow had 95 children (49♂46♀) with CF under its care. All children over 2 years had their BMI centile calculated. In all children over four years, mean FEV1% predicted was calculated. The number of outpatient clinics and inpatient admissions over a three year period was noted for all children over three years old.

The Scottish Index of Multiple Deprivation (SIMD) ranks the 6505 postcode districts in Scotland in order of deprivation, and a rank was obtained for each child’ postcode.

SMID rank was plotted against BMI, mean FEV1% predicted, outpatient appointments and inpatient admissions, with any correlations noted.

Result 83 children had BMI centile recorded (mean 45.4, range 0.4–98), 66 children had FEV1 % predicted calculated (mean 92.4%, range 50.4–146%). Mean SMID ranking was 2763 (range 33–6499.). The mean number of respiratory outpatient clinics attended was 23.1 (range 18–33), total outpatient clinics attended was 25.8 (range 18–48) and inpatient admissions was 4.3 (range 0–20) over three years.

No correlation was shown between SMID rank and BMI centile (r2 = 0.0025), mean FEV1% predicted (r2 = 0.0025), respiratory clinics attended (r2 = 0.0121), total outpatients attended (r2 = 0.0263) and inpatient admissions (r2 = 0.0078).

Conclusion Relative deprivation does not correlate with BMI centile or FEV1% predicted in this population of CF children and is not associated with the level of clinical input required.

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