Clinical changes of patients with cystic fibrosis during transition from pediatric to adult care.
OBJECTIVE
To evaluate the clinical changes of adults with cystic fibrosis (CF) during transition from a pediatric to adult CF center.


METHODS
Data were collected at the time of transfer, 1 year earlier and 1 year later, for all patients in our adult CF center arriving from one of the three pediatric CF centers in Paris between January 2001 and June 2004.


RESULTS
Sixty-three of the 68 patients (transferred at a median age of 21.0 years) were regularly attending this adult CF center after 1 year and one had died. The mean number of outpatient visits increased in the year after transfer (5.7 vs. 3.8 in the year before, p < .001). The occurrence of clinical events and the rate of bronchial colonization did not change. Pseudomonas aeruginosa was found in about 60% of patients at any time. Pulmonary function declined regularly with no statistically significant difference in the rate of decline between the 2 years of follow-up (FEV 1 was 54.7% predicted at transfer). Nutritional status remained stable (mean body mass index was 19.1 kg/m2). The number and duration of oral and i.v. antibiotic courses did not change, but more patients received them at home (p < .001) and self-administered physiotherapy after transfer (p = .001). The proportion of students decreased from 79.3% to 48.1% (p = .02) and the proportion in the workforce increased from 12.7% to 20.4% after transfer.


CONCLUSIONS
Patients with CF remained clinically stable during transition and progressively acquired autonomy.
Duguépéroux
Ingrid
I
CRCM-service de Pneumologie, Hôpital Cochin, APHP, Paris, France.
Tamalet
Aline
A
Sermet-Gaudelus
Isabelle
I
Le Bourgeois
Muriel
M
Gérardin
Michèle
M
Desmazes-Dufeu
Nadine
N
Hubert
Dominique
D
D000293:Adolescent; D000295:Adolescent Medicine; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003550:Cystic Fibrosis / Q000150:complications* / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D007388:Internal Medicine; D008168:Lung / Q000503:physiopathology; D008297:Male; D010372:Pediatrics; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D055815:Young Adult
D000900:Anti-Bacterial Agents