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Respir Med. 2015 Sep;109(9):1138-46. doi: 10.1016/j.rmed.2015.06.013. Epub 2015 Jun 25.

Prognostic value of variables derived from the six-minute walk test in patients with COPD: Results from the ECLIPSE study.

Author information

1
Department of Research and Education; CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands. Electronic address: vasilisandrianopoulos@ciro-horn.nl.
2
Department of Research and Education; CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
3
Department of Respiratory Medicine, School of Clinical Science, University of Liverpool, United Kingdom.
4
Department of Research and Education; CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands.
5
Department of Clinical Science, University of Bergen, Bergen, Norway.
6
Thorax Institute, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERES, Barcelona, Spain.
7
University of Edinburgh, Medical Research Council Centre for Inflammation Research, The Queen's Medical Research Institute, Edinburgh, United Kingdom.
8
Pulmonary and Critical Care Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
9
GSK Research and Development, King of Prussia, Philadelphia, PA, USA.
10
Department of Physical Education and Sport Sciences, National and Kapodistrian University of Athens, Greece.
11
Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark; Respiratory and Allergy Research Group, Manchester Academic Health Science Center, University of Manchester, Manchester, UK.
12
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
13
Department of Research and Education; CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands; REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.

Abstract

In addition to the six-min walk distance (6 MWD), other six-min walk test (6 MWT) derived variables, such as mean walk-speed (6MWSpeed), 6-min walk-work (6 MWW), distance-saturation product (DSP), exercise-induced oxygen desaturation (EID), and unintended stops may be useful for the prediction of mortality and hospitalization in patients with chronic obstructive pulmonary disease (COPD). We studied the association between 6 MWT-derived variables and mortality as well as hospitalization in COPD patients and compared it with the BODE index. A three-year prospective study (ECLIPSE) to evaluate the prognostic value of 6 MWT-derived variables in 2010 COPD patients. Cox's proportional-hazard regressions were performed to estimate 3-year mortality and hospitalization. During the follow-up, 193 subjects died and 622 were hospitalized. An adjusted Cox's regression model of hazard ratio [HR] for impaired 6 MWT-derived variables was significant referring to: mortality (6 MWD ≤334 m [2.30], 6MWSpeed ≤0.9 m/sec [2.15], 6 MWW ≤20000 m kg [2.17], DSP ≤290 m% [2.70], EID ≤88% [1.75], unintended stops [1.99]; and hospitalization (6 MWW ≤27000 m kg [1.23], EID ≤88% [1.25], BODE index ≥3 points [1.40]; all p ≤ 0.05). The 6 MWT-derived variables have an additional predictive value of mortality in patients with COPD. The 6 MWW, EID and the BODE index refine the prognosis of hospitalization.

KEYWORDS:

COPD; Exercise physiology; Exercise testing; Hospitalization; Mortality; Prognostic markers

PMID:
26143282
DOI:
10.1016/j.rmed.2015.06.013
[Indexed for MEDLINE]
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