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Predicting long-term mortality with two different criteria of exercise-induced desaturation in COPD

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Abstract
ackground: There are few reports on exercise-induced desaturation (EID) as a predictor of mortality in chronic obstructive pulmonary disease (COPD). However, the definitions of EID vary in published reports. The main purpose was to evaluate the association between EID and long-term mortality by applying two criteria of EID.

Methods: A total of 507 subjects were selected from the Korean Obstructive Lung Disease cohort. EID was assessed using the 6-min walk test (6MWT) and defined using two different criteria [1]: post-6MWT oxygen saturation (SpO2) of ≤88% (criterion A) and [2] post-6MWT SpO2 < 90% or a decrease of ≥4% compared to baseline (criterion B).

Results: The prevalence of EID was 5.1% based on criterion A and 13.0% based on criterion B. Regardless of the criteria used, mortality was higher in the EID group than in the non-EID group (A: 50 vs. 11.4%, B: 33.3 vs. 10.4%) during up to 161 months of follow-up. COPD patients without EID survived significantly longer than those with EID (A: 143.5 vs. 92.9, B: 144.8 vs. 115.2 months). Multivariate Cox regression analysis revealed that COPD patients with EID had a 2.4-fold increased risk of death by criterion A (adjusted HR 2.375; 95% CI: 1.217-4.637; P = 0.011). The risk of death increased in COPD patients with EID by criterion B, but the difference was not statistically significant.

Conclusions: COPD patients with EID demonstrated significantly higher long-term mortality than those without EID. The EID criterion A has a better predictive value for mortality in COPD.

Keywords: Chronic obstructive pulmonary disease; Exercise-induced desaturation; Mortality.
Author(s)
서준범오연목이상도이재승Changhwan KimChin Kook RheeJin Hwa LeeJi-Yong MoonKwang Ha YooSeong Yong LimYong Bum ParkYousang Ko
Issued Date
2021
Type
Article
Keyword
Chronic obstructive pulmonary diseaseExercise-induced desaturationMortality
DOI
10.1016/j.rmed.2021.106393
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7106
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2518740941&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Predicting%20long-term%20mortality%20with%20two%20different%20criteria%20of%20exercise-induced%20desaturation%20in%20COPD&amp;offset=0&amp;pcAvailability=true
Publisher
RESPIRATORY MEDICINE
Location
영국
Language
영어
ISSN
0954-6111
Citation Volume
182
Citation Number
0
Citation Start Page
106393
Citation End Page
106393
Appears in Collections:
Medicine > Medicine
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