Influence of diabetes on survival in patients with cystic fibrosis before and after lung transplantation

Don Hayes, Alpa V. Patel, Sylvester M. Black, Karen S. McCoy, Stephen Kirkby, Joseph D. Tobias, Heidi - Mansour, Bryan A. Whitson

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background The influence of diabetes mellitus (DM) on survival in patients with cystic fibrosis (CF) before and after lung transplantation is not well studied. Methods To determine the influence of DM in patients with CF, the United Network for Organ Sharing database (2005-2013) was queried for 2 cohorts: first-time lung transplant candidates who were not transplanted and first-time transplant recipients. Results A total of 679 patients with CF had data on DM status at listing and did not undergo transplantation. In this cohort, DM was associated with significant increase in mortality hazard as shown by an adjusted multivariate Cox model fitted to the whole cohort (hazard ratio [HR], 1.4; 95% confidence interval [CI], 1.1-1.8; P =.012) and by a Cox model stratified on pairs of DM and non-DM patients matched on the propensity of having DM at listing (HR, 1.9; 95% CI, 1.2-2.9; P =.003). In comparison, a total of 1464 patients with CF had data on DM status at listing and received a transplant, but DM at listing was not associated with posttransplant survival. The lack of association between DM and mortality hazard was evident in a multivariate Cox regression model fitted to the whole sample (HR, 1.0; 95% CI, 0.82-1.2; P =.98) and a Cox regression model stratified on matched pairs of DM and non-DM patients (HR, 1.1; 95% CI, 0.82-1.5; P =.56). Conclusions The presence of DM is associated with significantly increased risk for death in patients with CF on the wait list before lung transplantation, but does not influence survival after transplantation.

Original languageEnglish (US)
Pages (from-to)707-713e2
JournalJournal of Thoracic and Cardiovascular Surgery
Volume150
Issue number3
DOIs
StatePublished - Sep 1 2015

Fingerprint

Lung Transplantation
Cystic Fibrosis
Diabetes Mellitus
Survival
Proportional Hazards Models
Confidence Intervals
Transplantation
Transplants
Mortality
Databases

Keywords

  • advanced lung disease
  • cystic fibrosis
  • diabetes mellitus
  • lung transplantation
  • survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Hayes, D., Patel, A. V., Black, S. M., McCoy, K. S., Kirkby, S., Tobias, J. D., ... Whitson, B. A. (2015). Influence of diabetes on survival in patients with cystic fibrosis before and after lung transplantation. Journal of Thoracic and Cardiovascular Surgery, 150(3), 707-713e2. https://doi.org/10.1016/j.jtcvs.2015.06.041

Influence of diabetes on survival in patients with cystic fibrosis before and after lung transplantation. / Hayes, Don; Patel, Alpa V.; Black, Sylvester M.; McCoy, Karen S.; Kirkby, Stephen; Tobias, Joseph D.; Mansour, Heidi -; Whitson, Bryan A.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 150, No. 3, 01.09.2015, p. 707-713e2.

Research output: Contribution to journalArticle

Hayes, Don ; Patel, Alpa V. ; Black, Sylvester M. ; McCoy, Karen S. ; Kirkby, Stephen ; Tobias, Joseph D. ; Mansour, Heidi - ; Whitson, Bryan A. / Influence of diabetes on survival in patients with cystic fibrosis before and after lung transplantation. In: Journal of Thoracic and Cardiovascular Surgery. 2015 ; Vol. 150, No. 3. pp. 707-713e2.
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abstract = "Background The influence of diabetes mellitus (DM) on survival in patients with cystic fibrosis (CF) before and after lung transplantation is not well studied. Methods To determine the influence of DM in patients with CF, the United Network for Organ Sharing database (2005-2013) was queried for 2 cohorts: first-time lung transplant candidates who were not transplanted and first-time transplant recipients. Results A total of 679 patients with CF had data on DM status at listing and did not undergo transplantation. In this cohort, DM was associated with significant increase in mortality hazard as shown by an adjusted multivariate Cox model fitted to the whole cohort (hazard ratio [HR], 1.4; 95{\%} confidence interval [CI], 1.1-1.8; P =.012) and by a Cox model stratified on pairs of DM and non-DM patients matched on the propensity of having DM at listing (HR, 1.9; 95{\%} CI, 1.2-2.9; P =.003). In comparison, a total of 1464 patients with CF had data on DM status at listing and received a transplant, but DM at listing was not associated with posttransplant survival. The lack of association between DM and mortality hazard was evident in a multivariate Cox regression model fitted to the whole sample (HR, 1.0; 95{\%} CI, 0.82-1.2; P =.98) and a Cox regression model stratified on matched pairs of DM and non-DM patients (HR, 1.1; 95{\%} CI, 0.82-1.5; P =.56). Conclusions The presence of DM is associated with significantly increased risk for death in patients with CF on the wait list before lung transplantation, but does not influence survival after transplantation.",
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AU - McCoy, Karen S.

AU - Kirkby, Stephen

AU - Tobias, Joseph D.

AU - Mansour, Heidi -

AU - Whitson, Bryan A.

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N2 - Background The influence of diabetes mellitus (DM) on survival in patients with cystic fibrosis (CF) before and after lung transplantation is not well studied. Methods To determine the influence of DM in patients with CF, the United Network for Organ Sharing database (2005-2013) was queried for 2 cohorts: first-time lung transplant candidates who were not transplanted and first-time transplant recipients. Results A total of 679 patients with CF had data on DM status at listing and did not undergo transplantation. In this cohort, DM was associated with significant increase in mortality hazard as shown by an adjusted multivariate Cox model fitted to the whole cohort (hazard ratio [HR], 1.4; 95% confidence interval [CI], 1.1-1.8; P =.012) and by a Cox model stratified on pairs of DM and non-DM patients matched on the propensity of having DM at listing (HR, 1.9; 95% CI, 1.2-2.9; P =.003). In comparison, a total of 1464 patients with CF had data on DM status at listing and received a transplant, but DM at listing was not associated with posttransplant survival. The lack of association between DM and mortality hazard was evident in a multivariate Cox regression model fitted to the whole sample (HR, 1.0; 95% CI, 0.82-1.2; P =.98) and a Cox regression model stratified on matched pairs of DM and non-DM patients (HR, 1.1; 95% CI, 0.82-1.5; P =.56). Conclusions The presence of DM is associated with significantly increased risk for death in patients with CF on the wait list before lung transplantation, but does not influence survival after transplantation.

AB - Background The influence of diabetes mellitus (DM) on survival in patients with cystic fibrosis (CF) before and after lung transplantation is not well studied. Methods To determine the influence of DM in patients with CF, the United Network for Organ Sharing database (2005-2013) was queried for 2 cohorts: first-time lung transplant candidates who were not transplanted and first-time transplant recipients. Results A total of 679 patients with CF had data on DM status at listing and did not undergo transplantation. In this cohort, DM was associated with significant increase in mortality hazard as shown by an adjusted multivariate Cox model fitted to the whole cohort (hazard ratio [HR], 1.4; 95% confidence interval [CI], 1.1-1.8; P =.012) and by a Cox model stratified on pairs of DM and non-DM patients matched on the propensity of having DM at listing (HR, 1.9; 95% CI, 1.2-2.9; P =.003). In comparison, a total of 1464 patients with CF had data on DM status at listing and received a transplant, but DM at listing was not associated with posttransplant survival. The lack of association between DM and mortality hazard was evident in a multivariate Cox regression model fitted to the whole sample (HR, 1.0; 95% CI, 0.82-1.2; P =.98) and a Cox regression model stratified on matched pairs of DM and non-DM patients (HR, 1.1; 95% CI, 0.82-1.5; P =.56). Conclusions The presence of DM is associated with significantly increased risk for death in patients with CF on the wait list before lung transplantation, but does not influence survival after transplantation.

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