Clinical Changes of Patients with Cystic Fibrosis during Transition from Pediatric to Adult Care

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/m 2). 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.