School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK; Sheffield Adult CF Centre, Northern General Hospital, Sheffield, UK.
School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
J Cyst Fibros. 2018 May;17(3):360-367. doi: 10.1016/j.jcf.2017.10.005. Epub 2017 Oct 23.
The Epidemiologic Study of Cystic Fibrosis using 1995-1996 and 2003-2005 data found that CF centres with lowest FEV tended to use fewer intravenous antibiotics. We repeated the analyses using 2013-2014 UK CF registry data to determine if this was still the case.
Analysing data for 2013 and 2014 separately, 28 adult CF centres were ranked according to median % age-adjusted FEV. The top 7 centres were placed in the 'upper quarter' (best FEV), the bottom 7 centres in 'lower quarter' (lowest FEV), and the rest in 'middle half'. IV use was stratified according to %FEV, then compared between the three groups.
Centres in the 'upper quarter' and 'middle half' used significantly more IV antibiotics compared to centres in the 'lower quarter' (van Elteren test P-value<0.001). Regression analyses showed that people with CF attending centres in the 'upper quarter' or 'middle half' are 30-50% more likely to receive at least one IV course per year compared to people attending centres in the 'lower quarter'.
CF centres with lowest FEV are still distinguished by lower use of intravenous antibiotics.
使用 1995-1996 年和 2003-2005 年的数据进行的囊性纤维化流行病学研究发现,FEV 最低的 CF 中心往往使用较少的静脉内抗生素。我们使用 2013-2014 年英国 CF 登记处的数据重复了这些分析,以确定是否仍然如此。
分别分析 2013 年和 2014 年的数据,根据中位年龄调整后的 FEV 将 28 个成人 CF 中心进行排名。前 7 个中心被置于“上四分位数”(最佳 FEV),后 7 个中心置于“下四分位数”(最低 FEV),其余中心置于“中间一半”。根据 %FEV 对 IV 使用进行分层,然后在三组之间进行比较。
与“下四分位数”中心相比,“上四分位数”和“中间一半”中心使用的静脉内抗生素明显更多(van Elteren 检验 P 值<0.001)。回归分析表明,与在“下四分位数”中心就诊的 CF 患者相比,在“上四分位数”或“中间一半”中心就诊的 CF 患者每年接受至少一次 IV 疗程的可能性高 30-50%。
FEV 最低的 CF 中心仍然以静脉内抗生素使用较少为特征。