Spitzer Nicole, Legare Timothy B, Patel Priyanshi, Toselli Nicholas, Livingston Floyd
Ophthalmology, University of Central Florida College of Medicine, Orlando, USA.
Surgery, University of Central Florida College of Medicine, Orlando, USA.
Cureus. 2018 Jul 25;10(7):e3048. doi: 10.7759/cureus.3048.
The prevalence of attention-deficit/hyperactivity disorder (ADHD) in pediatric cystic fibrosis (CF) patients is comparable to the general population, but the effects of ADHD on CF treatment and the outcomes have been minimally investigated.
Two cohorts were retrospectively reviewed, pediatric patients with comorbid CF/ADHD and patients with CF only. Each patient with CF/ADHD was age and sex-matched to a CF-only patient based on their most recent pulmonary office visit. Each patient was reviewed for forced expiratory volume in one-second percent predicted (FEV1%pred), body mass index (BMI) percentile, and hospitalizations for one year prior to the last pulmonary visit.
A total of 624 patients with CF were identified, with 52 having co-morbid CF/ADHD (8.3%). Of those identified, 46 met inclusion criteria and were analyzed in the CF/ADHD cohort. The mean total hospital admissions between the CF/ADHD cohort and the CF-only cohort were not statistically significant (2.22 vs 1.834, p=.467). The difference between the BMI percentiles was not statistically significant (48.634 vs 38.634, p=.135). The difference between FEV1%pred was statistically significant at 84% for the CF/ADHD group and 74% for the CF-only group (p=.042).
The difference in total hospital admissions between the CF/ADHD cohort and the CF-only cohort did not reach statistical significance, but the study was underpowered. There was a significant difference between FEV1%pred between the two groups, in favor of the comorbid CF/ADHD population. More research is needed to further evaluate the effects of a comorbid ADHD diagnosis on outcomes in the CF pediatric population.
注意力缺陷多动障碍（ADHD）在小儿囊性纤维化（CF）患者中的患病率与普通人群相当，但ADHD对CF治疗及预后的影响鲜有研究。
回顾性分析两个队列，即合并CF/ADHD的儿科患者和仅患CF的患者。根据最近一次肺部门诊就诊情况，将每例CF/ADHD患者与仅患CF的患者按年龄和性别进行匹配。回顾每位患者在最后一次肺部就诊前一年的一秒用力呼气容积占预计值百分比（FEV1%pred）、体重指数（BMI）百分位数及住院情况。
共识别出624例CF患者，其中52例合并CF/ADHD（8.3%）。在这些患者中，46例符合纳入标准并在CF/ADHD队列中进行分析。CF/ADHD队列与仅患CF队列的平均总住院次数无统计学差异（2.22 vs 1.834，p = 0.467）。BMI百分位数之间的差异无统计学意义（48.634 vs 38.634，p = 0.135）。CF/ADHD组的FEV1%pred为84%，仅患CF组为74%，差异有统计学意义（p = 0.042）。
CF/ADHD队列与仅患CF队列的总住院次数差异未达到统计学意义，但该研究效能不足。两组之间的FEV1%pred存在显著差异，CF/ADHD合并症患者情况更佳。需要更多研究来进一步评估ADHD合并症诊断对CF儿科患者预后的影响。
