Risk factors for increased need for intravenous antibiotics for pulmonary exacerbations in adult patients with cystic fibrosis.
BACKGROUND
Pulmonary exacerbations (P Exs) are important in cystic fibrosis (CF). They are very common, and are associated with poor quality of life. P Exs are regarded as an important end point in clinical trials. Risk factors associated with increase in P Exs have not been examined at a large scale. This study investigates factors associated with P Exs in a large cohort of adolescent and adult patients.


METHODS
This is a cross-sectional study on data collected in the South and West Regions in England in 2002. Patients aged 16 years and over were included. Data on age, gender, FEV(1), body mass index (BMI), infection with Pseudomonas aeruginosa (Pa) and on CF-related diabetes were included in the analysis. P Ex was defined as an episode treated with IV antibiotics. Forward stepwise multiple regression analysis was performed with the number of P Exs being the independent variable. The rest of the variables were considered to be the dependent variables.


RESULTS
Data from 341 patients (194 female), mean age (SD), 24.9 (8.9) years were available. In 2002, a total of 599 P Exs were reported, median 1.00 range 0-16 P Exs. Using stepwise multiple regression analysis factors associated with increased number of P Exs were: infection with Pa (t-value -5.0, P < 0.0001), FEV(1), (t-value -4.9, P < 0.0001) and diabetes mellitus, (t-value -2.1, P = 0.04). Age, gender and BMI did not influence the annual number of exacerbations.


CONCLUSIONS
In this study, risk factors for P Exs were found to be as follows: growth of Pa in the sputum, reduced FEV1 and CF-related diabetes mellitus.
Jarad
N A
NA
The Adult CF Centre, Bristol Royal Infirmary, Bristol, UK. Nabil.Jarad@ubht.nhs.uk
Giles
K
K
D000328:Adult; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000382:microbiology*; D008297:Male; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000453:epidemiology; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology