help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Published ahead of print on August 15, 2002, doi:10.1164/rccm.200202-087OC
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200202-087OCv1
166/12/1550    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Mayer-Hamblett, N.
Right arrow Articles by Aitken, M. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Mayer-Hamblett, N.
Right arrow Articles by Aitken, M. L.
American Journal of Respiratory and Critical Care Medicine Vol 166. pp. 1550-1555, (2002)
© 2002 American Thoracic Society

Original Article

Developing Cystic Fibrosis Lung Transplant Referral Criteria Using Predictors of 2-Year Mortality

Nicole Mayer-Hamblett, Margaret Rosenfeld, Julia Emerson, Christopher H. Goss and Moira L. Aitken

Departments of Pediatrics and Medicine, University of Washington; and Statistical Analysis Unit, Cystic Fibrosis Therapeutics Development Network Coordinating Center, Children's Hospital and Regional Medical Center, Seattle, Washington

Correspondence and requests for reprints should be addressed to Nicole Mayer-Hamblett, Ph.D., Department of Pediatrics, University of Washington, 4800 Sand Point Way N.E., Box 5371, CL-11, Seattle, WA 98105-0371. E-mail: nhambl{at}chmc.org

The first objective of our study was to develop a model identifying the best clinical predictors of 2-year mortality among patients with cystic fibrosis (CF), to assist in selection of appropriate candidates for lung transplantation. Using multivariate logistic regression, we found that age, height, FEV1, respiratory microbiology, number of hospitalizations for pulmonary exacerbations, and number of home intravenous antibiotic courses were all significant predictors of 2-year mortality among 14,572 patients in the Cystic Fibrosis Foundation National Patient Registry who were 6 years of age or older in 1996. The second objective was to compare the diagnostic accuracy of our model when used to guide referral for lung transplant with that of the widely used criterion of an FEV1 of less than 30% predicted. Surprisingly, this well-fitting model derived from the largest collection of data available on patients with CF provided no better diagnostic accuracy than the simpler FEV1 criterion. Both had high negative predictive values (98 and 97%, respectively) but only modest positive predictive values (33 and 28%, respectively). Transplant referral decisions based either on a multivariate logistic model or on the criterion of an FEV1 of less than 30% predicted are likely to result in high rates of premature referral. Better clinical predictors of short-term mortality among patients with CF are needed.

Key Words: cystic fibrosis • mortality • lung transplantation • logistic models




This article has been cited by other articles:


Home page
 ThoraxHome page
M Loeve, P T. W van Hal, P Robinson, P A de Jong, M H Lequin, W C Hop, T J Williams, G D Nossent, and H A Tiddens
The spectrum of structural abnormalities on CT scans from patients with CF with severe advanced lung disease
Thorax, October 1, 2009; 64(10): 876 - 882.
[Abstract] [Full Text] [PDF]

Home page
 Palliat MedHome page
S. Bourke, S. Doe, A. Gascoigne, K Heslop, M Fields, D Reynolds, and K Mannix
An integrated model of provision of palliative care to patients with cystic fibrosis
Palliative Medicine, September 1, 2009; 23(6): 512 - 517.
[Abstract] [PDF]

Home page
 Proc Am Thorac SocHome page
M. Kreider and R. M. Kotloff
Selection of Candidates for Lung Transplantation
Proceedings of the ATS, January 15, 2009; 6(1): 20 - 27.
[Abstract] [Full Text] [PDF]

Home page
 ACCP Pulmonary Med Brd RevHome page
S. M. Levine
Lung Transplantation
ACCP Pulmonary Med Brd Rev, January 1, 2009; 25(0): 563 - 584.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. T. Saavedra, G. J. Hughes, L. A. Sanders, M. Carr, D. M. Rodman, C. D. Coldren, M. W. Geraci, S. D. Sagel, F. J. Accurso, J. West, et al.
Circulating RNA Transcripts Identify Therapeutic Response in Cystic Fibrosis Lung Disease
Am. J. Respir. Crit. Care Med., November 1, 2008; 178(9): 929 - 938.
[Abstract] [Full Text] [PDF]

Home page
 Nutr Clin PractHome page
A. von Drygalski and J. Biller
Anemia in Cystic Fibrosis: Incidence, Mechanisms, and Association With Pulmonary Function and Vitamin Deficiency
Nutr Clin Pract, October 1, 2008; 23(5): 557 - 563.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
J W Wilson, R M du Bois, and T E King Jr
Challenges in pulmonary fibrosis: 8 {middle dot} The need for an international registry for idiopathic pulmonary fibrosis
Thorax, March 1, 2008; 63(3): 285 - 287.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. Stern, B. Wiedemann, P. Wenzlaff, and on behalf of the German Cystic Fibrosis Quality As
From registry to quality management: the German Cystic Fibrosis Quality Assessment project 1995 2006
Eur. Respir. J., January 1, 2008; 31(1): 29 - 35.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
M. P. Boyle
Adult Cystic Fibrosis
JAMA, October 17, 2007; 298(15): 1787 - 1793.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
N. Mayer-Hamblett, B. W. Ramsey, and R. A. Kronmal
Advancing Outcome Measures for the New Era of Drug Development in Cystic Fibrosis
Proceedings of the ATS, August 1, 2007; 4(4): 370 - 377.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
C. H. Goss and A. L. Quittner
Patient-reported Outcomes in Cystic Fibrosis
Proceedings of the ATS, August 1, 2007; 4(4): 378 - 386.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
N. Mayer-Hamblett, M. L. Aitken, F. J. Accurso, R. A. Kronmal, M. W. Konstan, J. L. Burns, S. D. Sagel, and B. W. Ramsey
Association between Pulmonary Function and Sputum Biomarkers in Cystic Fibrosis
Am. J. Respir. Crit. Care Med., April 15, 2007; 175(8): 822 - 828.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. Hadjiliadis
Special Considerations for Patients With Cystic Fibrosis Undergoing Lung Transplantation
Chest, April 1, 2007; 131(4): 1224 - 1231.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
C. H Goss and J. L Burns
Exacerbations in cystic fibrosis {middle dot} 1: Epidemiology and pathogenesis
Thorax, April 1, 2007; 62(4): 360 - 367.
[Abstract] [Full Text] [PDF]

Home page
 J. Med. Genet.Home page
K. Buranawuti, M. P Boyle, S. Cheng, L. L Steiner, K. McDougal, M D. Fallin, C. Merlo, P. L Zeitlin, B. J Rosenstein, P. J Mogayzel Jr, et al.
Variants in mannose-binding lectin and tumour necrosis factor {alpha} affect survival in cystic fibrosis
J. Med. Genet., March 1, 2007; 44(3): 209 - 214.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
E. F. McKone, C. H. Goss, and M. L. Aitken
CFTR Genotype as a Predictor of Prognosis in Cystic Fibrosis.
Chest, November 1, 2006; 130(5): 1441 - 1447.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
J K Block, K L Vandemheen, E Tullis, D Fergusson, S Doucette, D Haase, Y Berthiaume, N Brown, P Wilcox, P Bye, et al.
Predictors of pulmonary exacerbations in patients with cystic fibrosis infected with multi-resistant bacteria
Thorax, November 1, 2006; 61(11): 969 - 974.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. A. Belkin, N. R. Henig, L. G. Singer, C. Chaparro, R. C. Rubenstein, S. X. Xie, J. Y. Yee, R. M. Kotloff, D. A. Lipson, and G. R. Bunin
Risk Factors for Death of Patients with Cystic Fibrosis Awaiting Lung Transplantation
Am. J. Respir. Crit. Care Med., March 15, 2006; 173(6): 659 - 666.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. H. Goss, G. D. Rubenfeld, B. W. Ramsey, and M. L. Aitken
Clinical Trial Participants Compared with Nonparticipants in Cystic Fibrosis
Am. J. Respir. Crit. Care Med., January 1, 2006; 173(1): 98 - 104.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
P. A. Flume, C. Strange, X. Ye, M. Ebeling, T. Hulsey, and L. L. Clark
Pneumothorax in Cystic Fibrosis
Chest, August 1, 2005; 128(2): 720 - 728.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
T. M. Egan and R. M. Kotloff
Pro/Con Debate: Lung Allocation Should Be Based on Medical Urgency and Transplant Survival and Not on Waiting Time*
Chest, July 1, 2005; 128(1): 407 - 415.
[Full Text] [PDF]

Home page
 ChestHome page
S. D. Nathan
Lung Transplantation: Disease-Specific Considerations for Referral
Chest, March 1, 2005; 127(3): 1006 - 1016.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. Kraemer, A. Blum, A. Schibler, R. A. Ammann, and S. Gallati
Ventilation Inhomogeneities in Relation to Standard Lung Function in Patients with Cystic Fibrosis
Am. J. Respir. Crit. Care Med., February 15, 2005; 171(4): 371 - 378.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. B. Rosenbluth, K. Wilson, T. Ferkol, and D. P. Schuster
Lung Function Decline in Cystic Fibrosis Patients and Timing for Lung Transplantation Referral
Chest, August 1, 2004; 126(2): 412 - 419.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A.R. Glanville and M. Estenne
Indications, patient selection and timing of referral for lung transplantation
Eur. Respir. J., November 1, 2003; 22(5): 845 - 852.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. L. Gibson, J. L. Burns, and B. W. Ramsey
Pathophysiology and Management of Pulmonary Infections in Cystic Fibrosis
Am. J. Respir. Crit. Care Med., October 15, 2003; 168(8): 918 - 951.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. Tobin
Pediatrics, Surfactant, and Cystic Fibrosis in AJRCCM 2002
Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 333 - 344.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. Tobin
Chronic Obstructive Pulmonary Disease, Pollution, Pulmonary Vascular Disease, Transplantation, Pleural Disease, and Lung Cancer in AJRCCM 2002
Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 356 - 370.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. G. Noone and T. M. Egan
Cystic Fibrosis: When to Refer for Lung Transplantation-Is the Answer Clear?
Am. J. Respir. Crit. Care Med., December 15, 2002; 166(12): 1531 - 1532.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2002 American Thoracic Society