Predictors of mortality in adults with cystic fibrosis

被引:110
作者
Courtney, J. M.
Bradley, J.
Mccaughan, J.
O'connor, T. M.
Shortt, C.
Bredin, C. P.
Bradbury, I.
Elborn, J. S.
机构
[1] Belfast City Hosp, Adult Cyst Fibrosis Unit, Belfast BT9 7AB, Antrim, North Ireland
[2] Queens Univ Belfast, Dept Microbiol, Belfast, Antrim, North Ireland
[3] Univ Ulster, Hlth & Rehabil Sci Res Inst, Belfast, Antrim, North Ireland
[4] Cork Univ Hosp, Adult Cyst Fibrosis Unit, Cork, Ireland
[5] Univ Ulster, Dept Med Stat, Belfast, Antrim, North Ireland
关键词
cystic fibrosis; mortality; predictors; microbiology; genetics; adults;
D O I
10.1002/ppul.20619
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Assessment 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 FEV, (%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) FEV, %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/m(2) in comparison to those remaining alive, 20.7 (3.4) kg/m(2), 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 Delta F508 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.
引用
收藏
页码:525 / 532
页数:8
相关论文
共 45 条
[21]   MUCOID PSEUDOMONAS-AERUGINOSA IS A MARKER OF POOR SURVIVAL IN CYSTIC-FIBROSIS [J].
HENRY, RL ;
MELLIS, CM ;
PETROVIC, L .
PEDIATRIC PULMONOLOGY, 1992, 12 (03) :158-161
[22]   CLINICAL-FEATURES, SURVIVAL RATE, AND PROGNOSTIC FACTORS IN YOUNG-ADULTS WITH CYSTIC-FIBROSIS [J].
HUANG, NN ;
SCHIDLOW, DV ;
SZATROWSKI, TH ;
PALMER, J ;
LARAYACUASAY, LR ;
YEUNG, W ;
HARDY, K ;
QUITELL, L ;
FIEL, S .
AMERICAN JOURNAL OF MEDICINE, 1987, 82 (05) :871-879
[23]   PSEUDOMONAS CEPACIA INFECTION IN CYSTIC-FIBROSIS - AN EMERGING PROBLEM [J].
ISLES, A ;
MACLUSKY, I ;
COREY, M ;
GOLD, R ;
PROBER, C ;
FLEMING, P ;
LEVISON, H .
JOURNAL OF PEDIATRICS, 1984, 104 (02) :206-210
[24]   SEVERITY OF CYSTIC-FIBROSIS IN PATIENTS HOMOZYGOUS AND HETEROZYGOUS FOR DELTA-F508 MUTATION [J].
JOHANSEN, HK ;
NIR, M ;
HOIBY, N ;
KOCH, C ;
SCHWARTZ, M .
LANCET, 1991, 337 (8742) :631-634
[25]   THE RELATION BETWEEN GENOTYPE AND PHENOTYPE IN CYSTIC-FIBROSIS - ANALYSIS OF THE MOST COMMON MUTATION (DELTA-F508) [J].
KEREM, E ;
COREY, M ;
KEREM, BS ;
ROMMENS, J ;
MARKIEWICZ, D ;
LEVISON, H ;
TSUI, LC ;
DURIE, P .
NEW ENGLAND JOURNAL OF MEDICINE, 1990, 323 (22) :1517-1522
[26]   PREDICTION OF MORTALITY IN PATIENTS WITH CYSTIC-FIBROSIS [J].
KEREM, E ;
REISMAN, J ;
COREY, M ;
CANNY, GJ ;
LEVISON, H .
NEW ENGLAND JOURNAL OF MEDICINE, 1992, 326 (18) :1187-1191
[27]   RELATIVE UNDERWEIGHT IN CYSTIC-FIBROSIS AND ITS PROGNOSTIC VALUE [J].
KRAEMER, R ;
RUDEBERG, A ;
HADORN, B ;
ROSSI, E .
ACTA PAEDIATRICA SCANDINAVICA, 1978, 67 (01) :33-37
[28]   Cross infection between cystic fibrosis patients colonised with Burkholderia cepacia [J].
Ledson, MJ ;
Gallagher, MJ ;
Corkill, JE ;
Hart, CA ;
Walshaw, MJ .
THORAX, 1998, 53 (05) :432-436
[29]   PERSON-TO-PERSON TRANSMISSION OF PSEUDOMONAS-CEPACIA BETWEEN PATIENTS WITH CYSTIC-FIBROSIS [J].
LIPUMA, JJ ;
DASEN, SE ;
NIELSON, DW ;
STERN, RC ;
STULL, TL .
LANCET, 1990, 336 (8723) :1094-1096
[30]   Clinical outcome in relation to care in centres specialising in cystic fibrosis: cross sectional study [J].
Mahadeva, R ;
Webb, K ;
Westerbeek, RC ;
Carroll, NR ;
Dodd, ME ;
Bilton, D ;
Lomas, DA .
BMJ-BRITISH MEDICAL JOURNAL, 1998, 316 (7147) :1771-+