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Routine spirometry in cystic fibrosis patients: impact on pulmonary exacerbation diagnosis and FEV(1) decline

OBJECTIVE: Pulmonary disease in cystic fibrosis (CF) is characterised by recurrent episodes of pulmonary exacerbations (PExs), with acute and long-term declines in lung function (FEV(1)). The study sought to determine whether routine spirometry increases the frequency of PEx diagnosis, resulting in...

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Autores principales: de Aquino, Carolina Silva Barboza, Rodrigues, Joaquim Carlos, da Silva-Filho, Luiz Vicente Ribeiro Ferreira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Pneumologia e Tisiologia 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262437/
https://www.ncbi.nlm.nih.gov/pubmed/35674545
http://dx.doi.org/10.36416/1806-3756/e20210237
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author de Aquino, Carolina Silva Barboza
Rodrigues, Joaquim Carlos
da Silva-Filho, Luiz Vicente Ribeiro Ferreira
author_facet de Aquino, Carolina Silva Barboza
Rodrigues, Joaquim Carlos
da Silva-Filho, Luiz Vicente Ribeiro Ferreira
author_sort de Aquino, Carolina Silva Barboza
collection PubMed
description OBJECTIVE: Pulmonary disease in cystic fibrosis (CF) is characterised by recurrent episodes of pulmonary exacerbations (PExs), with acute and long-term declines in lung function (FEV(1)). The study sought to determine whether routine spirometry increases the frequency of PEx diagnosis, resulting in benefits to long-term pulmonary function. METHODS: CF patients in the 5- to 18-year age bracket were followed for 1 year, during which they underwent spirometry before every medical visit. The main variables were the frequency of PEx diagnosis and use of antibiotics; the use of spirometry as a criterion for PEx diagnosis (a decline ≥ 10% in baseline FEV(1)); and median percent predicted FEV(1) over time. The data were compared with those for the previous 24-month period, when spirometry was performed electively every 6 months. RESULTS: The study included 80 CF patients. PExs were diagnosed in 27.5% of the visits, with a mean frequency of 1.44 PExs per patient/year in 2014 vs. 0.88 PExs per patient/year in 2012 (p = 0.0001) and 1.15 PExs per patient/year in 2013 (p = 0.05). FEV(1) was used as a diagnostic feature in 83.5% of PExs. In 21.9% of PExs, the decision to initiate antibiotics was solely based on an acute decline in FEV(1). The median percent predicted FEV(1) during the follow-up year was 85.7%, being 78.5% in 2013 and 76.8% in 2012 (p > 0.05). The median percent predicted FEV(1) remained above 80% during the two years after the study. CONCLUSIONS: Routine spirometry is associated with higher rates of diagnosis and treatment of PExs, possibly impacting long-term pulmonary function.
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spelling pubmed-92624372022-09-03 Routine spirometry in cystic fibrosis patients: impact on pulmonary exacerbation diagnosis and FEV(1) decline de Aquino, Carolina Silva Barboza Rodrigues, Joaquim Carlos da Silva-Filho, Luiz Vicente Ribeiro Ferreira J Bras Pneumol Original Article OBJECTIVE: Pulmonary disease in cystic fibrosis (CF) is characterised by recurrent episodes of pulmonary exacerbations (PExs), with acute and long-term declines in lung function (FEV(1)). The study sought to determine whether routine spirometry increases the frequency of PEx diagnosis, resulting in benefits to long-term pulmonary function. METHODS: CF patients in the 5- to 18-year age bracket were followed for 1 year, during which they underwent spirometry before every medical visit. The main variables were the frequency of PEx diagnosis and use of antibiotics; the use of spirometry as a criterion for PEx diagnosis (a decline ≥ 10% in baseline FEV(1)); and median percent predicted FEV(1) over time. The data were compared with those for the previous 24-month period, when spirometry was performed electively every 6 months. RESULTS: The study included 80 CF patients. PExs were diagnosed in 27.5% of the visits, with a mean frequency of 1.44 PExs per patient/year in 2014 vs. 0.88 PExs per patient/year in 2012 (p = 0.0001) and 1.15 PExs per patient/year in 2013 (p = 0.05). FEV(1) was used as a diagnostic feature in 83.5% of PExs. In 21.9% of PExs, the decision to initiate antibiotics was solely based on an acute decline in FEV(1). The median percent predicted FEV(1) during the follow-up year was 85.7%, being 78.5% in 2013 and 76.8% in 2012 (p > 0.05). The median percent predicted FEV(1) remained above 80% during the two years after the study. CONCLUSIONS: Routine spirometry is associated with higher rates of diagnosis and treatment of PExs, possibly impacting long-term pulmonary function. Sociedade Brasileira de Pneumologia e Tisiologia 2022-05-27 /pmc/articles/PMC9262437/ /pubmed/35674545 http://dx.doi.org/10.36416/1806-3756/e20210237 Text en © 2022 Sociedade Brasileira de Pneumologia e Tisiologia https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited.
spellingShingle Original Article
de Aquino, Carolina Silva Barboza
Rodrigues, Joaquim Carlos
da Silva-Filho, Luiz Vicente Ribeiro Ferreira
Routine spirometry in cystic fibrosis patients: impact on pulmonary exacerbation diagnosis and FEV(1) decline
title Routine spirometry in cystic fibrosis patients: impact on pulmonary exacerbation diagnosis and FEV(1) decline
title_full Routine spirometry in cystic fibrosis patients: impact on pulmonary exacerbation diagnosis and FEV(1) decline
title_fullStr Routine spirometry in cystic fibrosis patients: impact on pulmonary exacerbation diagnosis and FEV(1) decline
title_full_unstemmed Routine spirometry in cystic fibrosis patients: impact on pulmonary exacerbation diagnosis and FEV(1) decline
title_short Routine spirometry in cystic fibrosis patients: impact on pulmonary exacerbation diagnosis and FEV(1) decline
title_sort routine spirometry in cystic fibrosis patients: impact on pulmonary exacerbation diagnosis and fev(1) decline
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262437/
https://www.ncbi.nlm.nih.gov/pubmed/35674545
http://dx.doi.org/10.36416/1806-3756/e20210237
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