title: Variation in lung function is associated with worse clinical outcomes in cystic fibrosis.
abstract: OBJECTIVE
  To determine whether the variation in lung function over one year is associated with worse clinical outcomes, as well as with a decline in lung function in the following years, in patients with cystic fibrosis (CF).
  
  
  METHODS
  This was a retrospective study involving CF patients (4-19 years of age), evaluated over a three-year period. We evaluated demographic characteristics, chronic Pseudomonas aeruginosa infection, antibiotic use, hospitalization, six-minute walk distance (6MWD), and lung function. The inclusion criterion was having undergone pulmonary function testing at least three times in the first year and at least once in each of the next two years.
  
  
  RESULTS
  We evaluated 35 CF patients. The variation in FEV1 in the first year (ΔFEV1) was greater among those who, in the third year, showed reduced FEV1, had a below-average 6MWD, or were hospitalized than among those with normal FEV1, normal 6MWD, or no hospital admissions, in that same year (p < 0.05), although no such difference was found for antibiotic use in the third year. Subjects showing a ΔFEV1 ≥ 10% also showed a greater decline in FEV1 over the two subsequent years (p = 0.04). The ΔFEV1 also showed an inverse correlation with absolute FEV1 in the third year (r = -0.340, p = 0.04) and with the rate of FEV1 decline (r = -0.52, p = 0.001). Linear regression identified ΔFEV1 as a predictor of FEV1 decline (coefficient of determination, 0.27).
  
  
  CONCLUSIONS
  Significant variation in lung function over one year seems to be associated with a higher subsequent rate of FEV1 decline and worse clinical outcomes in CF patients. Short-term ΔFEV1 might prove useful as a predictor of CF progression in clinical practice.
authors.affiliation: Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: João Paulo
authors.initials: JP
authors.lastname: Heinzmann-Filho
authors.affiliation: Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Leonardo Araujo
authors.initials: LA
authors.lastname: Pinto
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Paulo José Cauduro
authors.initials: PJ
authors.lastname: Marostica
authors.affiliation: Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Márcio Vinícius Fagundes
authors.initials: MV
authors.lastname: Donadio
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D016014:Linear Models; D008168:Lung / Q000503:physiopathology*; D008297:Male; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D016138:Walking; D055815:Young Adult