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10.1016/j.jcf.2015.11.005

http://scihub22266oqcxt.onion/10.1016/j.jcf.2015.11.005
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C4828327!4828327!26704622
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suck abstract from ncbi


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pmid26704622      J+Cyst+Fibros 2016 ; 15 (2): 196-203
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  • Predictors of non-referral of patients with cystic fibrosis for lung transplant evaluation in the United States #MMPMID26704622
  • Ramos KJ; Quon BS; Psoter KJ; Lease ED; Mayer-Hamblett N; Aitken ML; Goss CH
  • J Cyst Fibros 2016[Mar]; 15 (2): 196-203 PMID26704622show ga
  • Background: Lung transplantation is an intervention that improves survival for adult patients with cystic fibrosis (CF). Some patients with CF are never referred for lung transplant evaluation despite meeting physiologic criteria for referral. Methods: We performed a retrospective analysis of adult patients (? 18 years of age) in the Cystic Fibrosis Foundation Patient Registry (CFFPR), eligible for their first evaluation for lung transplantation during the years 2001?2008 based on FEV1 <30% predicted in two consecutive years. Results: Within the CFFPR, 1240 patients met eligibility criteria. Eight hundred and nine (65.2%) were referred for lung transplant evaluation, and 431 (34.8%) were not referred. In a multivariable model, Medicaid insurance (OR 1.79, 95% CI 1.29?2.47), older age (per 5 year increase; OR 1.25, 95% CI 1.13?1.39), lack of high school graduate education (OR 2.27, 95% CI 1.42?3.64), and Burkholderia cepacia complex sputum culture positivity (OR 2.48, 95% CI 1.50?4.12) were associated with non-referral, while number of pulmonary exacerbations (OR 0.93, 95% CI 0.87?0.99) and supplemental oxygen use (OR 0.59, 95% CI 0.43?0.81) were associated with increased referral. Conclusions: Despite meeting lung function criteria for lung transplant evaluation, 35% of patients with CF had not yet been referred to a lung transplant center. Predictors of non-referral included markers of low socioeconomic status, older age and Burkholderia cepacia complex sputum culture. Further work is needed to understand the outcomes for non-referred patients in order to refine referral recommendations in this population.
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