Comparison among pulmonary function test results, the Shwachman-Kulczycki score and the Brasfield score in patients with cystic fibrosis.

OBJECTIVE

To study correlations among pulmonary function, chest radiology and clinical status in cystic fibrosis.

METHODS

A retrospective cross-sectional study was performed to evaluate chest X-rays and clinical charts of patients treated at the Hospital de Clínicas de Porto Alegre. Spirometry findings, Shwachman-Kulczycki (S-K) scores and Brasfield scores were analyzed.

RESULTS

The final sample consisted of 40 patients (mean age 9.72 +/- 3.27). The following mean S-K scores were obtained: total, 80.87 +/- 10.24; general activity, 24.75 +/- 1.1; physical examination, 18.87 +/- 4.59; nutrition, 21.87 +/- 4.18; radiology, 15.37 +/- 5.23. The mean Brasfield score was 18.2 +/- 4. The pulmonary function test results, in percentage of predicted, were as follows: forced vital capacity (FVC), 82.99 +/- 14.36%; forced expiratory volume in one second (FEV1), 83.62 +/- 18.26%; and forced expiratory flow between 25 and 75% of FVC (FEF25-75), 74.63 +/- 2.53%. The S-K score correlated moderately with FVC, whereas it correlated strongly with FEV1 and FEF25-75. The Brasfield score correlated strongly with the S-K total and radiology score, whereas it correlated moderately with pulmonary function. Physical examination correlated moderately with FVC, FEV1 and FEF25-75; as did nutrition with FEF25-75; and radiology with FEV1 and FEF25-75. General activity was the domain that had the greatest influence on the total S-K score.

CONCLUSIONS

These two scoring systems are complementary, correlating with each other, as well as with pulmonary function tests. The radiology domain of the S-K scoring system is a good alternative to the Brasfield score.