Treatment and demographic factors affecting time to next pulmonary exacerbation in cystic fibrosis

Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society
Donald R VanDevanterMichael W Konstan

Abstract

Pulmonary exacerbations (PEx) are important CF clinical events. We studied time to next PEx following intravenous (IV) antibiotic PEx treatment among Cleveland Ohio CF center patients occurring between January 2010 and September 2014. Patient demographics, clinical presentations, and treatments were modeled by Cox proportional hazards regression to identify covariates associated with time to next PEx. 193 patients were treated for PEx; 155 had a subsequent IV-treated PEx. Six covariates were associated with future PEx hazard: number of PEx in the prior year (hazard ratio 25.1 for ≥3 and 4.4 for 1-2 prior-year PEx versus none; P<.0001), IV treatment duration in weeks (1.2; P=.0004), percent hospital treatment (1.1; P=.0018), and chronic inhaled aminoglycosides (2.5; P<.0001), leukotriene modifiers (1.8; P=.0031), and high dose ibuprofen (0.52; P=.0006). Time to next PEx was profoundly associated with prior-year PEx, suggestive of high-risk PEx phenotypes that warrant recognition and further study.

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Citations

Oct 20, 2015·Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society·Don B Sanders
Jan 7, 2017·Current Medical Research and Opinion·Jaime L RubinMichael S Schechter
Oct 7, 2017·The Cochrane Database of Systematic Reviews·Pamela McCormackKevin W Southern
Mar 8, 2018·Pediatric Pulmonology·Heather S KirkhamGregory S Sawicki
Jul 7, 2018·Pediatric Pulmonology·Michael S Schechter
Feb 23, 2019·The American Journal of Clinical Nutrition·Vin TangprichaJessica A Alvarez
May 19, 2018·The European Respiratory Journal·Marieke van HorckEdward Dompeling
May 14, 2016·Pediatric Pulmonology·Adrienne P Savant, Susanna A McColley
Aug 29, 2019·Journal of Managed Care & Specialty Pharmacy·Mark A TesellKaren Stevens
Jan 11, 2021·Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society·Márcio Vinícius Fagundes DonadioEvanirso Silva Aquino
Jul 30, 2016·Pediatric Clinics of North America·Don B Sanders, Aliza K Fink
May 29, 2016·Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society·Patrick A FlumeBonnie W Ramsey
Dec 4, 2021·BMJ Open Respiratory Research·Kathryn BresnickCecile LeCamus
Dec 16, 2021·The Cochrane Database of Systematic Reviews·Paul BurnhamRuth Stewart

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