RT Journal Article
SR Electronic
T1 Predictors of pulmonary exacerbations in patients with cystic fibrosis infected with multi-resistant bacteria
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 969
OP 974
DO 10.1136/thx.2006.061366
VO 61
IS 11
A1 J K Block
A1 K L Vandemheen
A1 E Tullis
A1 D Fergusson
A1 S Doucette
A1 D Haase
A1 Y Berthiaume
A1 N Brown
A1 P Wilcox
A1 P Bye
A1 S Bell
A1 M Noseworthy
A1 L Pedder
A1 A Freitag
A1 N Paterson
A1 S D Aaron
YR 2006
UL http://thorax.bmj.com/content/61/11/969.abstract
AB Background: This study examined characteristics of adult and adolescent patients with cystic fibrosis (CF) to determine factors associated with an increased risk of pulmonary exacerbations. Methods: 249 patients with CF infected with multidrug resistant bacteria were recruited and prospectively followed for up to 4.5 years until they experienced a pulmonary exacerbation severe enough to require intravenous antibiotics. Multivariable regression analyses were used to compare the characteristics of patients who experienced an exacerbation with those who did not. Results: 124 of the 249 patients (50%) developed a pulmonary exacerbation during the first year and 154 (62%) experienced an exacerbation during the 4.5 year study period. Factors predictive of exacerbations in a multivariable survival model were younger age (OR 0.98, 95% CI 0.96 to 0.99), female sex (OR 1.45, 95% CI 1.07 to 1.95), lower forced expiratory volume in 1 second (FEV1) (OR 0.98, 95% CI 0.97 to 0.99), and a previous history of multiple pulmonary exacerbations (OR 3.16, 95% CI 1.93 to 5.17). Chronic use of inhaled corticosteroids was associated with an increased risk of exacerbation (OR 1.92, 95% CI 1.00 to 3.71) during the first study year. Conclusions: Patients who experience pulmonary exacerbations are more likely to be younger, female, using inhaled steroids, have a lower FEV1, and a history of multiple previous exacerbations. It is hoped that knowledge of these risk factors will allow better identification and closer monitoring of patients who are at high risk of exacerbations.