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Clinical characteristics and outcomes in adult cystic fibrosis patients with severe lung disease in Porto Alegre, southern Brazil

BACKGROUND: Advanced lung disease in adult cystic fibrosis (CF) drives most clinical care requirements. The aim was to evaluate outcome (time to death while in the study) in a cohort of adult CF patients with severe lung disease, and to determine the association among baseline patient characteristic...

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Autores principales: Silva, Guilherme Figueiredo, J. Simmonds, Nicholas, Roth Dalcin, Paulo de Tarso
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366886/
https://www.ncbi.nlm.nih.gov/pubmed/32677921
http://dx.doi.org/10.1186/s12890-020-01223-6
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author Silva, Guilherme Figueiredo
J. Simmonds, Nicholas
Roth Dalcin, Paulo de Tarso
author_facet Silva, Guilherme Figueiredo
J. Simmonds, Nicholas
Roth Dalcin, Paulo de Tarso
author_sort Silva, Guilherme Figueiredo
collection PubMed
description BACKGROUND: Advanced lung disease in adult cystic fibrosis (CF) drives most clinical care requirements. The aim was to evaluate outcome (time to death while in the study) in a cohort of adult CF patients with severe lung disease, and to determine the association among baseline patient characteristics and outcome. METHODS: A retrospective cohort study was performed and clinical records between 2000 and 2015 were reviewed. Severe lung disease was defined as forced expiratory volume in the first second (FEV(1)) < 30% of predicted. Outcomes of all patients, including their date of death or transplantation, were determined till January 1st, 2016. Clinical data were recorded at the entry date. RESULTS: Among 39 subjects included in the study, 20 (51.3%) died, 16 (41.0%) underwent bilateral lung transplantation, and 3 were alive at the end of the study period. Two variables were independently associated with death: body mass index (BMI ≥ 18.5 kg/m(2)) (HR = 0.78, 95% CI = 0.64–0.96 and p = 0.017) and use of tobramycin inhalation therapy (HR = 3.82, 95% CI = 1.38–10.6 and p = 0.010). Median survival was 37 (95% CI = 16.4–57.6) months. The best cut-off point for BMI was 18.5 kg/m(2). Median survival in patients with BMI < 18.5 kg/m(2) was 36 months (95% CI = 18.7–53.3). CONCLUSION: Median survival of CF subjects with FEV(1) < 30% was 37 months. BMI and tobramycin inhalation therapy were independently associated with death. Median survival in patients with BMI < 18.5 kg/m(2) was significantly lower than in patients with BMI ≥ 18.5 kg/m(2). The association of tobramycin inhalation with death was interpreted as confounding by severity (use was reserved for advanced lung disease).
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spelling pubmed-73668862020-07-20 Clinical characteristics and outcomes in adult cystic fibrosis patients with severe lung disease in Porto Alegre, southern Brazil Silva, Guilherme Figueiredo J. Simmonds, Nicholas Roth Dalcin, Paulo de Tarso BMC Pulm Med Research Article BACKGROUND: Advanced lung disease in adult cystic fibrosis (CF) drives most clinical care requirements. The aim was to evaluate outcome (time to death while in the study) in a cohort of adult CF patients with severe lung disease, and to determine the association among baseline patient characteristics and outcome. METHODS: A retrospective cohort study was performed and clinical records between 2000 and 2015 were reviewed. Severe lung disease was defined as forced expiratory volume in the first second (FEV(1)) < 30% of predicted. Outcomes of all patients, including their date of death or transplantation, were determined till January 1st, 2016. Clinical data were recorded at the entry date. RESULTS: Among 39 subjects included in the study, 20 (51.3%) died, 16 (41.0%) underwent bilateral lung transplantation, and 3 were alive at the end of the study period. Two variables were independently associated with death: body mass index (BMI ≥ 18.5 kg/m(2)) (HR = 0.78, 95% CI = 0.64–0.96 and p = 0.017) and use of tobramycin inhalation therapy (HR = 3.82, 95% CI = 1.38–10.6 and p = 0.010). Median survival was 37 (95% CI = 16.4–57.6) months. The best cut-off point for BMI was 18.5 kg/m(2). Median survival in patients with BMI < 18.5 kg/m(2) was 36 months (95% CI = 18.7–53.3). CONCLUSION: Median survival of CF subjects with FEV(1) < 30% was 37 months. BMI and tobramycin inhalation therapy were independently associated with death. Median survival in patients with BMI < 18.5 kg/m(2) was significantly lower than in patients with BMI ≥ 18.5 kg/m(2). The association of tobramycin inhalation with death was interpreted as confounding by severity (use was reserved for advanced lung disease). BioMed Central 2020-07-16 /pmc/articles/PMC7366886/ /pubmed/32677921 http://dx.doi.org/10.1186/s12890-020-01223-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Silva, Guilherme Figueiredo
J. Simmonds, Nicholas
Roth Dalcin, Paulo de Tarso
Clinical characteristics and outcomes in adult cystic fibrosis patients with severe lung disease in Porto Alegre, southern Brazil
title Clinical characteristics and outcomes in adult cystic fibrosis patients with severe lung disease in Porto Alegre, southern Brazil
title_full Clinical characteristics and outcomes in adult cystic fibrosis patients with severe lung disease in Porto Alegre, southern Brazil
title_fullStr Clinical characteristics and outcomes in adult cystic fibrosis patients with severe lung disease in Porto Alegre, southern Brazil
title_full_unstemmed Clinical characteristics and outcomes in adult cystic fibrosis patients with severe lung disease in Porto Alegre, southern Brazil
title_short Clinical characteristics and outcomes in adult cystic fibrosis patients with severe lung disease in Porto Alegre, southern Brazil
title_sort clinical characteristics and outcomes in adult cystic fibrosis patients with severe lung disease in porto alegre, southern brazil
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366886/
https://www.ncbi.nlm.nih.gov/pubmed/32677921
http://dx.doi.org/10.1186/s12890-020-01223-6
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