EARLY FOCAL ABNORMALITIES ON CHEST RADIOGRAPHS AND RESPIRATORY PROGNOSIS IN CHILDREN WITH CYSTIC-FIBROSIS

The variable rate of progression of respiratory disease in cystic fibr osis demands reliable prognostic markers for rational treatment. This study aims to determine whether or not focal abnormalities on chest ra diographs during the early clinical course of cystic fibrosis could be used as such a marker. A retrospective review of patient records was carried out. Demographic details, genotype, presentation, and course o f respiratory disease over the first 6 years were recorded for all pat ients, together with spirometry and chest radiograph scores at 7 and 1 3 years for surviving patients. Comparison was made between those with and those without documented focal opacification on chest radiography during the first 6 years of life. 30 patients satisfied the study ent ry criteria and had complete records available. Of these, 17 had focal consolidation documented during the first 6 years, and 13 did not. Su rvival was significantly worse in those with previous consolidation (p <0.01), as was peak expiratory flow at 7 years (p = 0.02). There were no other statistically significant differences between the groups, alt hough those with previous consolidation apparently had worse lung func tion and more advanced disease on chest radiography at both 7 and 13 y ears. This study suggests that early focal chest radiographic abnormal ities may predict a poorer outcome in cystic fibrosis.