OBJECTIVES: To characterize the rate of decline of forced expiratory volume in 1 second (FEV(1)) in children and adolescents with cystic fibrosis and to identify and compare risk factors associated with FEV(1) decline. STUDY DESIGN: The rate of decline in FEV(1)% predicted over 3 to 6 years in 3 different age groups was determined. Risk factors for decline were identified and compared among and within age groups as a function of disease severity with repeated-measures, mixed-model regression. RESULTS: Mean (+/-SD) baseline FEV(1)% predicted was 88.4% +/- 20.5% for 6- to 8-year-olds (n = 1811), 85.3% +/- 20.8% for 9- to 12-year-olds (n = 1696), and 78.4% +/- 22.0% for 13- to 17-year-olds (n = 1359). Decline in FEV(1)% predicted/year was -1.12, -2.39, and -2.34, respectively. High baseline FEV(1) and persistent crackles were significant independent risk factors for decline across all age groups. Female sex, Pseudomonas aeruginosa infection, low weight-for-age, sputum, wheezing, sinusitis, pulmonary exacerbations treated with intravenous antibiotics, elevated liver test results, and pancreatic insufficiency were also identified as independent risk factors in some age groups. CONCLUSIONS: This study identifies risk factors for FEV(1) decline in children and adolescents with cystic fibrosis. Clinicians should not be reassured by high lung function, particularly in young children, because this factor, among others, is independently associated with steeper decline in FEV(1).
OBJECTIVES: To characterize the rate of decline of forced expiratory volume in 1 second (FEV(1)) in children and adolescents with cystic fibrosis and to identify and compare risk factors associated with FEV(1) decline. STUDY DESIGN: The rate of decline in FEV(1)% predicted over 3 to 6 years in 3 different age groups was determined. Risk factors for decline were identified and compared among and within age groups as a function of disease severity with repeated-measures, mixed-model regression. RESULTS: Mean (+/-SD) baseline FEV(1)% predicted was 88.4% +/- 20.5% for 6- to 8-year-olds (n = 1811), 85.3% +/- 20.8% for 9- to 12-year-olds (n = 1696), and 78.4% +/- 22.0% for 13- to 17-year-olds (n = 1359). Decline in FEV(1)% predicted/year was -1.12, -2.39, and -2.34, respectively. High baseline FEV(1) and persistent crackles were significant independent risk factors for decline across all age groups. Female sex, Pseudomonas aeruginosa infection, low weight-for-age, sputum, wheezing, sinusitis, pulmonary exacerbations treated with intravenous antibiotics, elevated liver test results, and pancreatic insufficiency were also identified as independent risk factors in some age groups. CONCLUSIONS: This study identifies risk factors for FEV(1) decline in children and adolescents with cystic fibrosis. Clinicians should not be reassured by high lung function, particularly in young children, because this factor, among others, is independently associated with steeper decline in FEV(1).
Authors: Nicole Mayer-Hamblett; Richard A Kronmal; Ronald L Gibson; Margaret Rosenfeld; George Retsch-Bogart; Miriam M Treggiari; Jane L Burns; Umer Khan; Bonnie W Ramsey Journal: Pediatr Pulmonol Date: 2011-08-09
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Authors: Nicole Mayer-Hamblett; Margaret Rosenfeld; Ronald L Gibson; Bonnie W Ramsey; Hemantha D Kulasekara; George Z Retsch-Bogart; Wayne Morgan; Daniel J Wolter; Christopher E Pope; Laura S Houston; Bridget R Kulasekara; Umer Khan; Jane L Burns; Samuel I Miller; Lucas R Hoffman Journal: Am J Respir Crit Care Med Date: 2014-08-01 Impact factor: 21.405
Authors: Susanna A McColley; Michael W Konstan; Bonnie W Ramsey; J Stuart Elborn; Michael P Boyle; Claire E Wainwright; David Waltz; Montserrat Vera-Llonch; Gautham Marigowda; John G Jiang; Jaime L Rubin Journal: J Cyst Fibros Date: 2018-08-23 Impact factor: 5.482
Authors: Scott D Sagel; Brandie D Wagner; Margaret M Anthony; Peggy Emmett; Edith T Zemanick Journal: Am J Respir Crit Care Med Date: 2012-08-16 Impact factor: 21.405
Authors: Don B Sanders; Julia Emerson; Clement L Ren; Michael S Schechter; Ronald L Gibson; Wayne Morgan; Margaret Rosenfeld Journal: Ann Am Thorac Soc Date: 2015-08