Risk factors for rate of decline in FEV(1) 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.