Early referral to cystic fibrosis specialist centre impacts on respiratory outcome.
BACKGROUND
Published studies concerning the impact of specialist care on lung disease in cystic fibrosis remain limited and most are either biased due to comparison with historical controls and/or underpowered.


METHODS
In this retrospective multicentric study, data from all CF children fulfilling the following criteria were collected: 1) Age 6-<18 at the end of 2003; 2) diagnosis before 8 y; 3) follow-up in an accredited CF Belgian centre; 4) at least 1 spirometry and respiratory culture available for 2003. Group A included children referred > or =2 years after the diagnosis. Patients from Group A were then matched with a single early referred patient on the basis of 2 criteria: same centre, as closest age as possible (Group B).


RESULTS
Data from 217 children were collected (Group A: 67/217). Late referred patients had a lower FEV(1) (77.2%+/-22.4 vs 86.7% pred.+/-19.4, p=0.01) and a higher prevalence of Pseudomonas aeruginosa (38.6 vs 17.5%, p<0.05).


CONCLUSIONS
In this population of CF children, a delay of 6.1 y (vs 0.1 y) between diagnosis and referral to a specialist clinic resulted in poorer respiratory outcome at age 13.
Lebecque
P
P
St Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium. Patrick.Lebecque@uclouvain.be
Leonard
A
A
De Boeck
K
K
De Baets
F
F
Malfroot
A
A
Casimir
G
G
Desager
K
K
Godding
V
V
Leal
T
T
D000293:Adolescent; D001530:Belgium; D002648:Child; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D018450:Disease Progression; D006801:Humans; D017063:Outcome Assessment, Health Care; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012017:Referral and Consultation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity