Airway disease on chest computed tomography of preschool children with cystic fibrosis is associated with school‐age bronchiectasis

Airway wall thickening and mucus plugging are important characteristics of cystic fibrosis (CF) lung disease in the first 5 years of life.The aim of this study is to investigate the association of lung disease in preschool children (age, 2‐6) with bronchiectasis and other clinical outcome measures in the school age (age >7). Deidentified computed tomography‐scans were annotated using Perth‐Rotterdam annotated grid morphometric analysis for CF. Preschool %disease (a composite score of %airway wall thickening, %mucus plugging, and %bronchiectasis) and %MUPAT (a composite score of %airway wall thickening and %mucus plugging) were used as predictors for %bronchiectasis and several other school‐age clinical outcomes. For statistical analysis, we used regression analysis, linear mixed‐effects models and two‐way mixed models. Sixty‐one patients were included. %Disease increased significantly with age (P < .01). Preschool %disease and %MUPAT were significantly associated with school‐age %bronchiectasis (P < .01 and P < .01, respectively). No significant association was found between preschool %disease and %MUPAT and school‐age forced expiratory volume 1 (FEV1%) predicted and quality of life (P > .05). Cross‐sectional, %disease in school‐age was associated with a low FEV1% predicted and low quality of life (P = .01 and P = .007, respectively). %Disease can be considered an early marker of diffuse airways disease and is a risk factor for school‐age bronchiectasis.