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Exercise-induced desaturation in patients with chronic obstructive pulmonary disease on six-minute walk test.

Dogra AC, Gupta U, Sarkar M, Padam A - Lung India (2015 Jul-Aug)

Bottom Line: DS had significantly lower values of FEV1 (P < 0.001), FVC (P < 0.01) FEV1/FVC (P < 0.01) compared to NDS.EID had significant negative correlation with FEV1 (r = 0.31, P < 0.01), resting oxygen saturation (r = 0.549, P < 0.001) and 6MWD (r = 0.511, P < 0.001).Resting SpO2 ≤93% was found to a predictor of EID with a sensitivity and specificity of 83% and 78%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Physiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.

ABSTRACT

Background and objectives: Exercise-induced desaturation (EID) is associated with increased mortality in chronic obstructive pulmonary disease (COPD). However, the relationship of EID with anthropometric and clinical parameters of resting pulmonary function test and six-minute walk test (6MWT) in COPD remains unclear. The study was designed to assess the correlate of EID and to identify various possible predictors of EID in stable normoxemic patients of COPD.

Materials and methods: Sixty patients with stable COPD diagnosed and staged as per the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines underwent 6MWT. A drop in standard pulse oximetry (SpO2) of ≥4% or nadir up to ≤88% was defined as EID. Based on EID during 6MWT, two groups were formed: desaturators (DS) and nondesaturators (NDS). DS and NDS were compared for baseline and clinical characters by the Student's t-test while Pearson and Spearman rho correlation coefficient assessed strength of the association of anthropometric and clinical variables with EID. The predictors of EID were identified by logistic regression and receiver operator curve analysis.

Result: Out of 60 patients with stable COPD, 33 patients desaturated on exercise (n = 33/60). DS had significantly lower values of FEV1 (P < 0.001), FVC (P < 0.01) FEV1/FVC (P < 0.01) compared to NDS. EID had significant negative correlation with FEV1 (r = 0.31, P < 0.01), resting oxygen saturation (r = 0.549, P < 0.001) and 6MWD (r = 0.511, P < 0.001). Resting SpO2 ≤93% was found to a predictor of EID with a sensitivity and specificity of 83% and 78%, respectively.

Interpretation and conclusion: The 6MWT is a safe and sensitive test to recognize EID in normoxic stable COPD patients. Resting oxygen saturation is a good predictor of EID.

No MeSH data available.


Related in: MedlinePlus

ROC for baseline oxygen saturation via pulse oximetry as a screening test for EID AUROC is 0.85 (95%CI 0.62-0.89); P < 0.001
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Figure 1: ROC for baseline oxygen saturation via pulse oximetry as a screening test for EID AUROC is 0.85 (95%CI 0.62-0.89); P < 0.001

Mentions: The two variables that remained significant were baseline oxygen saturation with highly statistical significance with odds ratio (OR) of 1.37 (95% CI 0.89-2.12) (P < 0.001) and FEV1 with OR of 3.27 (P < 0.010). The model with the most baseline oxygen saturation was sensitive and its performance was quantified by calculating the area under the ROC curve [area under the receiver operating characteristic (AUROC) curve] of 0.85 (P < 0.001) [Figure 1]. A cut-off baseline SpO2 ≤93% was then determined that had sensitivity of 83% and specificity of 78% for predicting EID.


Exercise-induced desaturation in patients with chronic obstructive pulmonary disease on six-minute walk test.

Dogra AC, Gupta U, Sarkar M, Padam A - Lung India (2015 Jul-Aug)

ROC for baseline oxygen saturation via pulse oximetry as a screening test for EID AUROC is 0.85 (95%CI 0.62-0.89); P < 0.001
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4502194&req=5

Figure 1: ROC for baseline oxygen saturation via pulse oximetry as a screening test for EID AUROC is 0.85 (95%CI 0.62-0.89); P < 0.001
Mentions: The two variables that remained significant were baseline oxygen saturation with highly statistical significance with odds ratio (OR) of 1.37 (95% CI 0.89-2.12) (P < 0.001) and FEV1 with OR of 3.27 (P < 0.010). The model with the most baseline oxygen saturation was sensitive and its performance was quantified by calculating the area under the ROC curve [area under the receiver operating characteristic (AUROC) curve] of 0.85 (P < 0.001) [Figure 1]. A cut-off baseline SpO2 ≤93% was then determined that had sensitivity of 83% and specificity of 78% for predicting EID.

Bottom Line: DS had significantly lower values of FEV1 (P < 0.001), FVC (P < 0.01) FEV1/FVC (P < 0.01) compared to NDS.EID had significant negative correlation with FEV1 (r = 0.31, P < 0.01), resting oxygen saturation (r = 0.549, P < 0.001) and 6MWD (r = 0.511, P < 0.001).Resting SpO2 ≤93% was found to a predictor of EID with a sensitivity and specificity of 83% and 78%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Physiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.

ABSTRACT

Background and objectives: Exercise-induced desaturation (EID) is associated with increased mortality in chronic obstructive pulmonary disease (COPD). However, the relationship of EID with anthropometric and clinical parameters of resting pulmonary function test and six-minute walk test (6MWT) in COPD remains unclear. The study was designed to assess the correlate of EID and to identify various possible predictors of EID in stable normoxemic patients of COPD.

Materials and methods: Sixty patients with stable COPD diagnosed and staged as per the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines underwent 6MWT. A drop in standard pulse oximetry (SpO2) of ≥4% or nadir up to ≤88% was defined as EID. Based on EID during 6MWT, two groups were formed: desaturators (DS) and nondesaturators (NDS). DS and NDS were compared for baseline and clinical characters by the Student's t-test while Pearson and Spearman rho correlation coefficient assessed strength of the association of anthropometric and clinical variables with EID. The predictors of EID were identified by logistic regression and receiver operator curve analysis.

Result: Out of 60 patients with stable COPD, 33 patients desaturated on exercise (n = 33/60). DS had significantly lower values of FEV1 (P < 0.001), FVC (P < 0.01) FEV1/FVC (P < 0.01) compared to NDS. EID had significant negative correlation with FEV1 (r = 0.31, P < 0.01), resting oxygen saturation (r = 0.549, P < 0.001) and 6MWD (r = 0.511, P < 0.001). Resting SpO2 ≤93% was found to a predictor of EID with a sensitivity and specificity of 83% and 78%, respectively.

Interpretation and conclusion: The 6MWT is a safe and sensitive test to recognize EID in normoxic stable COPD patients. Resting oxygen saturation is a good predictor of EID.

No MeSH data available.


Related in: MedlinePlus