Clinical changes of patients with cystic fibrosis during transition from pediatric to adult care

J Adolesc Health. 2008 Nov;43(5):459-65. doi: 10.1016/j.jadohealth.2008.03.005. Epub 2008 Jun 16.

Abstract

Purpose: To evaluate the clinical changes of adults with cystic fibrosis (CF) during transition from a pediatric to adult CF center.

Methods: Data were collected at the time of transfer, 1 year earlier and 1 year later, for all patients in our adult CF center arriving from one of the three pediatric CF centers in Paris between January 2001 and June 2004.

Results: Sixty-three of the 68 patients (transferred at a median age of 21.0 years) were regularly attending this adult CF center after 1 year and one had died. The mean number of outpatient visits increased in the year after transfer (5.7 vs. 3.8 in the year before, p < .001). The occurrence of clinical events and the rate of bronchial colonization did not change. Pseudomonas aeruginosa was found in about 60% of patients at any time. Pulmonary function declined regularly with no statistically significant difference in the rate of decline between the 2 years of follow-up (FEV 1 was 54.7% predicted at transfer). Nutritional status remained stable (mean body mass index was 19.1 kg/m2). The number and duration of oral and i.v. antibiotic courses did not change, but more patients received them at home (p < .001) and self-administered physiotherapy after transfer (p = .001). The proportion of students decreased from 79.3% to 48.1% (p = .02) and the proportion in the workforce increased from 12.7% to 20.4% after transfer.

Conclusions: Patients with CF remained clinically stable during transition and progressively acquired autonomy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Medicine
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / pathology*
  • Cystic Fibrosis / therapy
  • Disease Progression
  • Female
  • Humans
  • Internal Medicine
  • Lung / physiopathology
  • Male
  • Pediatrics
  • Practice Patterns, Physicians'
  • Retrospective Studies
  • Young Adult

Substances

  • Anti-Bacterial Agents