School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
Sheffield Adult CF Centre, Northern General Hospital, Sheffield, UK.
Respirology. 2018 Feb;23(2):190-197. doi: 10.1111/resp.13174. Epub 2017 Sep 14.
Intravenous (i.v.) antibiotics are needed for rescue when preventative therapy fails to achieve stability among adults with cystic fibrosis (CF). Understanding the distribution of i.v. days can provide insight into the care that adults with CF need. We aim to determine the baseline characteristics that are associated with higher i.v. use, in particular to test the hypothesis that prior-year i.v. use is associated with future-year i.v. use.
This is a cross-sectional analysis of the 2013-2014 UK CF registry data. Stepwise logistic regression was performed using current-year i.v. days as the dependent variable, and demographic variables including prior-year i.v. days as the covariates. Based on these results, study sample was divided into clinically meaningful subgroups using analysis similar to tree-based method.
Data were available for 4269 adults in 2013 and 4644 adults in 2014. Prior-year i.v. use was the strongest predictor for current-year i.v. use followed by forced expiratory volume in 1 s (FEV ). Adults with high prior-year i.v. use (>14 days) continued to require high levels of i.v., regardless of FEV . Those with high prior-year i.v. use and FEV ≥70% had higher current-year i.v. days compared to adults with low prior-year i.v. use and FEV <40% (28 days, interquartile range (IQR): 11-41 days vs 14 days, IQR: 0-28 days; Mann-Whitney P-value <0.001 in 2013).
CF people with prior high levels of rescue often continue to need high levels of rescue even if they have good FEV . The reasons for this require further investigations.
对于患有囊性纤维化（CF）的成年人，如果预防治疗未能达到稳定，就需要静脉（i.v.）抗生素进行抢救。了解静脉天的分布情况可以深入了解 CF 成年人所需的护理。我们旨在确定与更高的静脉使用率相关的基线特征，特别是测试前一年静脉使用率与未来一年静脉使用率相关的假设。
这是对 2013-2014 年英国 CF 登记处数据的横断面分析。使用当前年度静脉天作为因变量，逐步逻辑回归，将人口统计学变量（包括前一年静脉天）作为协变量。基于这些结果，使用类似于基于树的方法的分析，将研究样本分为具有临床意义的亚组。
2013 年有 4269 名成年人和 2014 年有 4644 名成年人的数据可用。前一年的静脉使用率是当前年度静脉使用率的最强预测因素，其次是 1 秒用力呼气量（FEV ）。高前一年静脉使用率（>14 天）的成年人继续需要高水平的静脉，无论 FEV 如何。与低前一年静脉使用率和 FEV <40%的成年人相比，高前一年静脉使用率和 FEV ≥70%的成年人当前年度静脉天数更高（28 天，四分位距（IQR）：11-41 天比 14 天，IQR：0-28 天；2013 年 Mann-Whitney P 值<0.001）。
即使 FEV 良好，先前高水平急救的 CF 患者往往仍需要高水平的急救。需要进一步调查这种情况的原因。
