Abstract：
BACKGROUND: People with cystic fibrosis (PwCF) experience frequent symptoms associated with chronic lung disease. A complication of CF is a pulmonary exacerbation (PEx), which is often preceded by an increase in symptoms and a decline in lung function. A symptom cluster is when two or more symptoms co-occur and are related; symptom clusters have contributed meaningful knowledge in other diseases. The purpose of this study is to discover symptom clustering patterns in PwCF during a PEx to illuminate symptom phenotypes and assess differences in recovery from PExs.
METHODS: This study was a secondary, longitudinal analysis (N = 72). Participants at least 10 years of age and being treated with intravenous antibiotics for a CF PEx were enrolled in the United States. Symptoms were collected on treatment days 1-21 using the CF Respiratory Symptom Diary (CFRSD)-Chronic Respiratory Symptom Score (CRISS). K-means clustering was computed on day 1 symptom data to detect clustering patterns. Linear regression and multi-level growth models were performed.
RESULTS: Symptoms significantly clustered based on severity: low symptom (LS)-phenotype (n = 42), high symptom (HS)-phenotype (n = 30). HS-phenotype had worse symptoms and CRISS scores (p< 0.01) than LS-phenotype. HS-phenotype was associated with spending 5 more nights in the hospital annually (p< 0.01) than LS-phenotype. HS-phenotype had worse symptoms over 21 days than LS-phenotype (p< 0.0001).
CONCLUSIONS: Symptoms significantly cluster on day 1 of a CF-PEx. PwCF with HS-phenotype spend more nights in the hospital and are less likely to experience the same resolution in symptoms by the end of PEx treatment than LS-phenotype.
METHODS: This study was a secondary, longitudinal analysis (N = 72). Participants at least 10 years of age and being treated with intravenous antibiotics for a CF PEx were enrolled in the United States. Symptoms were collected on treatment days 1-21 using the CF Respiratory Symptom Diary (CFRSD)-Chronic Respiratory Symptom Score (CRISS). K-means clustering was computed on day 1 symptom data to detect clustering patterns. Linear regression and multi-level growth models were performed.
RESULTS: Symptoms significantly clustered based on severity: low symptom (LS)-phenotype (n = 42), high symptom (HS)-phenotype (n = 30). HS-phenotype had worse symptoms and CRISS scores (p< 0.01) than LS-phenotype. HS-phenotype was associated with spending 5 more nights in the hospital annually (p< 0.01) than LS-phenotype. HS-phenotype had worse symptoms over 21 days than LS-phenotype (p< 0.0001).
CONCLUSIONS: Symptoms significantly cluster on day 1 of a CF-PEx. PwCF with HS-phenotype spend more nights in the hospital and are less likely to experience the same resolution in symptoms by the end of PEx treatment than LS-phenotype.
摘要：
背景：囊性纤维化（PwCF）患者会出现与慢性肺部疾病相关的频繁症状。CF的并发症是肺加重（PEx），通常在症状增加和肺功能下降之前。症状群是指两个或多个症状共同出现并相关；症状群在其他疾病中贡献了有意义的知识。这项研究的目的是发现PEx期间PwCF中的症状聚类模式，以阐明症状表型并评估从PEx恢复的差异。
方法：这项研究是次要的，纵向分析(N=72)。在美国招募了至少10岁并正在接受CFPEx静脉注射抗生素治疗的参与者。使用CF呼吸症状日记(CFRSD)-慢性呼吸症状评分(CRISS)在治疗第1-21天收集症状。在第1天症状数据上计算K均值聚类以检测聚类模式。进行线性回归和多水平生长模型。
结果：根据严重程度，症状显着聚集：低症状（LS）表型（n=42），高症状（HS）表型（n=30）。HS-表型具有比LS-表型更差的症状和CRISS评分(p<0.01)。与LS-表型相比,HS-表型与每年在医院多住5晚相关(p<0.01)。HS-表型在21天内的症状比LS-表型更差(p<0.0001)。
结论：症状在CF-PEx的第1天显著聚集。与LS-表型相比,具有HS-表型的PwCF在医院花费更多的夜晚,并且在PEx治疗结束时不太可能经历相同的症状消退。
方法：这项研究是次要的，纵向分析(N=72)。在美国招募了至少10岁并正在接受CFPEx静脉注射抗生素治疗的参与者。使用CF呼吸症状日记(CFRSD)-慢性呼吸症状评分(CRISS)在治疗第1-21天收集症状。在第1天症状数据上计算K均值聚类以检测聚类模式。进行线性回归和多水平生长模型。
结果：根据严重程度，症状显着聚集：低症状（LS）表型（n=42），高症状（HS）表型（n=30）。HS-表型具有比LS-表型更差的症状和CRISS评分(p<0.01)。与LS-表型相比,HS-表型与每年在医院多住5晚相关(p<0.01)。HS-表型在21天内的症状比LS-表型更差(p<0.0001)。
结论：症状在CF-PEx的第1天显著聚集。与LS-表型相比,具有HS-表型的PwCF在医院花费更多的夜晚,并且在PEx治疗结束时不太可能经历相同的症状消退。
