VanDevanter Donald R, Morris Nathan J, Konstan Michael W
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
J Cyst Fibros. 2016 May;15(3):372-9. doi: 10.1016/j.jcf.2015.10.006. Epub 2015 Oct 23.
Single-center analyses have suggested that the number of CF pulmonary exacerbations (PEx) treated with intravenous antibiotics an individual has experienced in the prior year is significantly associated with their future PEx hazard.
We studied Prior-year PEx association with future PEx hazard by Cox proportional hazards regression among CF Foundation Patient Registry patients who experienced PEx after Jan 1, 2010.
Among 13,579 patients, those with 1, 2, 3, or ≥4 Prior-year PEx treated with intravenous antibiotics were at 1.8, 2.9, 4.8, and 8.7 higher PEx hazard vs those without (P<.0001). Adjustment with significant demographic and clinical covariates (univariate P≤.0001) reduced Prior-year PEx hazard ratios to 1.6, 2.4, 3.6, and 6.0 (P<.0001). No other covariates had adjusted hazard ratios of >1.7.
Prior-year PEx strongly associate with future PEx hazard and should be accounted for in prospective trials where treatment-associated change in PEx hazard is an efficacy outcome.
单中心分析表明,个体在前一年接受静脉抗生素治疗的囊性纤维化肺部加重(PEx)次数与他们未来发生PEx的风险显著相关。
我们通过Cox比例风险回归研究了2010年1月1日后经历过PEx的囊性纤维化基金会患者登记处患者中,前一年PEx与未来PEx风险的关联。
在13579名患者中,前一年接受静脉抗生素治疗1次、2次、3次或≥4次PEx的患者与未接受治疗的患者相比,发生PEx的风险分别高1.8倍、2.9倍、4.8倍和8.7倍(P<.0001)。对显著的人口统计学和临床协变量进行调整(单变量P≤.0001)后,前一年PEx的风险比降至1.6、2.4、3.6和6.0(P<.0001)。没有其他协变量的调整后风险比>1.7。
前一年的PEx与未来PEx风险密切相关,在以PEx风险的治疗相关变化作为疗效结果的前瞻性试验中应予以考虑。