Background: Median survival age in cystic fibrosis (CF) has increased in developed countries. Scarce literature exists about survival in Latin America, especially in Mexico. The aim of our study was to assess the median age of survival in CF patients and the impact of risk factors in Mexico over a 20-year period. Methods: We conducted a retrospective study with all patients registered and followed in the CF Center in Monterrey, Mexico from 2000 to 2020. Median survival age was the primary outcome, assessed with Kaplan-Meier analysis. The influence of clinical, biological, and demographic factors on survival was analyzed with Cox regression model. Results: Two-hundred five patients were included. Median survival for the cohort was 21.37 years (95% confidence interval [CI], 17.20-25.55). In the multivariate Cox regression model, low socioeconomic status (hazard ratio [HR], 4.21; 95% CI, 2.43-7.27), chronic Pseudomonas aeruginosa infection at 6 years (HR, 10.45; 95% CI, 5.66-19.28), and pancreatic insufficiency (HR, 3.13; 1.38-7.13) were independent risk factors for mortality. Conclusion:Median survival in Mexican patients with CF is lower than in highincome countries, and socioeconomic status plays a conspicuous role in the disparity. To increase patient survival for those residing in low-middle income countries, public health authorities must design policies that fully cover diagnosis and treatment strategies for the CF population.disparities, low-income countries, median survival age | INTRODUCTIONCystic fibrosis (CF) is a hereditary disease, transmitted in an autosomal recessive manner; its prevalence varies by country, according to ethnic composition. In Mexico, its prevalence is estimated to be approximately 1:8500 to 1:10,000 in live newborns. 1 Survival of those with CF has improved markedly in developed countries, due to early diagnosis, multidisciplinary care, aggressive nutritional supplementation, novel inhaled treatments, eradication of Pseudomonas aeruginosa, and lung transplantation. 2 Despite advances, there is a great deal of variability in disease progression, severity, and survival in different countries and geographic settings. 3,4 There are several factors related to survival, such as the cystic fibrosis transmembrane conductance regulator (CFTR) genotype, 5 initial presentation of the disease, 6 nutritional status, 7 sputum bacteriology, 8,9 diabetes, 10-12 socioeconomic status (SES), 13

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Background. Cystic fibrosis (CF) is an autosomal recessive disorder associated with an increased susceptibility to respiratory infections that cause progressive decline in lung function and lead to lung damage and chronic respiratory failure. To analyze the CF-related mortality trends in the Mexican population during a 22-year period.  We conducted a mortality trend analysis using death certificates data. Trends in CF-specific and in age-specific mortality rates were evaluated using Joinpoint regression analysis. Among subjects ≤40 years, 1184 CF-related deaths were identified. In 1999–2009 median age at death was 7 years compared to 10 years in 2010–2020. Overall mortality rate increased from 0.03 per 100,000 in 1999 to 0.06 per 100,000 in 2020. A decline in mortality rate for patients ≤28 days and an increase in mortality rate in older age groups was observed. Conclusion. The increasing trend in overall mortality, associated with a downward trend in neonatal mortality and an increase in median age at death is conceivably due to enhanced diagnosis, as well as major advances in treatment modalities, leading to higher survival rates. Key words: age at death, cystic fibrosis, epidemiology, low- and middle-income countries, mortality, survival rate.

Background. Median survival age in cystic fibrosis (CF) has increased in developed countries. Scarce literature exists about survival in Latin American, especially in Mexico. The aim of our study was to assess the median age of CF patients’ survival in Mexico over a 20-year period. Methods. We conducted a retrospective study, with all patients registered and followed in the CF Center in Monterrey, Mexico from 2000 to 2020. Median survival age was the primary outcome, assessed with the Kaplan-Meier analysis. Influence of clinical, biological, and demographic factors on survival were analyzed with the Cox regression model. Results. Two-hundred five patients were included. Median survival for the cohort was 21.37 years (95% CI 17.20 – 25.55). In the multivariate Cox regression model, low socioeconomic status (hazard ratio [HR] 4.21, 95% CI 2.43 – 7.27), chronic Pseudomonas aeruginosa (P. aeruginosa) infection at 6 years (HR 10.45, 95% CI 5.66 – 19.28), and pancreatic insufficiency (HR 3.13, 1.38 – 7.13) were independent risk factors for mortality. Conclusion. Median survival in Mexican patients with CF is lower than in high-income countries, and socioeconomic status plays a conspicuous role in the disparity. To increase patient survival for those residing in low-income countries, public health authorities must design policies that fully cover diagnosis and treatment strategies for the CF population.