Risk factors for rate of decline in FEV1 in adults with cystic fibrosis

BackgroundPreviously we assessed risk factors for FEV1 decline in children and adolescents using the Epidemiologic Study of Cystic Fibrosis (J Pediatr 2007;151:134-139); the current study assessed risk factors in adults.MethodsRisk factors for FEV1 decline over 3-5.5 years for ages 18-24 and ≥ 25 years were assessed using mixed-model regression.ResultsMean rates of FEV1 decline (% predicted/year) were − 1.92 for ages 18-24y (n = 2793) and − 1.45 for ages ≥ 25y (n = 1368). For the 18-24y group, B. cepacia, pancreatic enzyme use, multidrug-resistant P. aeruginosa, cough, mucoid P. aeruginosa, and female sex predicted greater decline; low baseline FEV1 and sinusitis predicted less decline. For the ≥ 25y group, only pancreatic enzyme use predicted greater decline; low baseline FEV1 and sinusitis predicted less decline.ConclusionsRisk factors for FEV1 decline in adults < 25 years are similar to those previously identified in children and adolescents; older adults had few statistically significant risk factors.