Background

Patients with cystic fibrosis (CF) present exercise intolerance and episodes of pulmonary exacerbations. This study aimed to evaluate the association of the distance covered on the modified shuttle test (MST), as well as other clinical variables (anthropometry, chronic colonization by Pseudomonas aeruginosa, lung function), with the risk of hospitalization for pulmonary exacerbation.

Methods

Cohort study including CF patients older than 6 years, from two specialized CF centers. All patients underwent a MST and a lung function test at the time of inclusion. Demographic, anthropometric and clinical data were collected. Free time until the first hospitalization, total days of hospitalization and use of antibiotics during the two years of follow-up were recorded.

Results

Sixty-seven patients with a mean (SD) age of 12.4 (5.2) years and forced expiratory volume in the first second (FEV₁) of 78.7% (22.4) were included. The mean distance covered (m) in the MST was 775.6 (255.7) (73.4 ± 19.5% of predicted). The distance achieved (MST) was considered as the main independent variable to predict the risk of hospitalization (Cox HR 0.97, p = 0.029). Patients who walked a distance of less than 80% of predicted in the MST showed an increase of 3.9 (95%CI 1.0–15.3) in the relative risk for hospitalization and significantly higher total number of days of hospitalization (p = 0.022).

Conclusion

There is an association between the distance covered in the MST and the risk of hospitalization in youths with CF. Patients with reduced exercise capacity presented a 3.9 times increase in the relative risk for hospitalization due to pulmonary exacerbation.

中文翻译：

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改良穿梭试验作为青少年囊性纤维化住院风险的预测指标：一项为期两年的随访研究

背景

患有囊性纤维化 (CF) 的患者存在运动不耐受和肺部恶化发作。本研究旨在评估改良穿梭试验 (MST) 覆盖的距离以及其他临床变量（人体测量学、铜绿假单胞菌慢性定植、肺功能）与肺部恶化住院风险之间的关系。

方法

队列研究包括来自两个专门的 CF 中心的 6 岁以上的 CF 患者。所有患者在纳入时都接受了 MST 和肺功能测试。收集了人口统计学、人体测量学和临床数据。记录第一次住院前的空闲时间、住院总天数和两年随访期间的抗生素使用情况。

结果

包括 67 名患者，平均 (SD) 年龄为 12.4 (5.2) 岁，第一秒用力呼气量 (FEV ₁ ) 为 78.7% (22.4)。MST 中覆盖的平均距离 (m) 为 775.6 (255.7)（预测值的 73.4 ± 19.5%）。达到的距离（MST）被认为是预测住院风险的主要自变量（Cox HR 0.97，p  = 0.029）。步行距离低于 MST 预测距离的 80% 的患者住院的相对风险增加了 3.9 (95%CI 1.0–15.3)，住院总天数显着增加 ( p  = 0.022)。

结论

MST 覆盖的距离与 CF 青少年的住院风险之间存在关联。运动能力降低的患者因肺部恶化而住院的相对风险增加了 3.9 倍。