Probability of treatment following acute decline in lung function in children with cystic fibrosis is related to baseline pulmonary function

Wayne J Morgan, Jeffrey S. Wagener, Ashley Yegin, David J. Pasta, Stefanie J. Millar, Michael W. Konstan

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective To determine whether the association between high forced expiratory volume in 1 second (FEV1) and increased rate of decline in FEV1 in children with cystic fibrosis could be due to less frequent intervention after acute declines (sudden decline events) in FEV1. Study design Patients with cystic fibrosis aged 6-17 years enrolled in the Epidemiologic Study of Cystic Fibrosis were assessed for a sudden decline event, defined as a 10% relative decline in FEV1% predicted from an average of 3 consecutive stable baseline spirometries. The likelihood of therapeutic intervention within 14 days before and 56 days after this event was then related to their baseline FEV1% predicted age-specific decile using a logistic regression adjusting for age group (6-12 years, 13-17 years) and presence of Pseudomonas aeruginosa on respiratory culture. Results A total of 10 888 patients had at least 1 sudden decline event in FEV1. Patients in the highest FEV1 decile were significantly less likely than those in the lowest decile to receive intravenous antibiotics (OR, 0.14; 95% CI, 0.11-0.18; P <.001) or be hospitalized (OR, 0.18; 95% CI, 0.14-0.23; P <.001) following decline. Conclusions Children and adolescents with high baseline lung function are less likely to receive a therapeutic intervention following an acute decline in FEV1, which may explain their greater rate of FEV1 decline.

Original languageEnglish (US)
JournalThe Journal of Pediatrics
Volume163
Issue number4
DOIs
StatePublished - Oct 2013

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Forced Expiratory Volume
Cystic Fibrosis
Lung
Therapeutics
Spirometry
Pseudomonas aeruginosa
Epidemiologic Studies
Age Groups
Logistic Models
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Probability of treatment following acute decline in lung function in children with cystic fibrosis is related to baseline pulmonary function. / Morgan, Wayne J; Wagener, Jeffrey S.; Yegin, Ashley; Pasta, David J.; Millar, Stefanie J.; Konstan, Michael W.

In: The Journal of Pediatrics, Vol. 163, No. 4, 10.2013.

Research output: Contribution to journalArticle

Morgan, Wayne J ; Wagener, Jeffrey S. ; Yegin, Ashley ; Pasta, David J. ; Millar, Stefanie J. ; Konstan, Michael W. / Probability of treatment following acute decline in lung function in children with cystic fibrosis is related to baseline pulmonary function. In: The Journal of Pediatrics. 2013 ; Vol. 163, No. 4.
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