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Early Desaturation During 6-Minute Walk Test is a Predictor of Mortality in COPD

  • COPD
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Abstract

Background

Oxygen desaturation during exercise is mainly observed in severe cases of chronic obstructive pulmonary disease (COPD) and is associated with a worse prognosis, but little is known about the type of desaturation that causes the greatest risk of mortality.

Material and Methods

We studied all of the 6-min walk tests performed periodically at a tertiary hospital over a period of 12 years in patients with moderate or severe COPD. We classified patients as non-desaturators if they did not suffer a drop in oxygen saturation (SpO2 < 88%) during the test, early desaturators if the time until desaturation was < 1 min, and non-early desaturators if it was longer than 1 min. The average length of follow-up per patient was 5.6 years.

Results

Of the 319 patients analyzed, 126 non-desaturators, 91 non-early desaturators and 102 early desaturators were identified. The mortality analysis showed that early desaturators had a mortality of 73%, while it was 38% for non-early desaturators and 28% for non-desaturators, with a survival of 5.9 years compared to 7.5 years and 9.6 years, respectively (hazard ratio of 3.50; 95% CI 2.3–5.3; p < 0.0001).

Conclusions

The early desaturation seen in patients with chronic obstructive pulmonary disease is associated with greater mortality and is likely responsible for the poor prognosis shown globally in patients who desaturate. The survival of patients with early desaturation is almost 4 years less with respect to non-desaturators, and they, thus, require closer observation.

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Abbreviations

COPD:

Chronic obstructive pulmonary disease

SpO2:

Peripheral oxygen saturation

6MWT:

6-Minute walk test

ND:

Non-desaturator patients

NED:

Non-early desaturator patients.

ED:

Early desaturator patients

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript

Author information

Authors and Affiliations

  1. Respiratory Department, Research Unit, University Hospital Nuestra Señora de Candelaria, Tenerife, Spain

    Ignacio García-Talavera & Juan Marco Figueira-Gonçalves

  2. Canary Tropical Disease and Public Health Institute. La Laguna University, La Laguna, Spain

    Juan Marco Figueira-Gonçalves

  3. Respiratory Department, University Hospital Lucas Augusti, Lugo, Spain

    Rafael Golpe

  4. Respiratory Department, University Hospital Galdakao, Galdakao, Bizkaia, Spain

    Cristobal Esteban & Amaia Aramburu

  5. BioCruces-Bizkaia Health Research Institute, Baracaldo, Spain

    Cristobal Esteban

  6. Health Services Research On Chronic Patients Network (REDISSEC). Red de Investigación en Cronicidad, Atención Primaria Y Promoción de La Salud (RICAPPS), Marbella, Spain

    Cristobal Esteban

  7. Respiratory Deptartment, University Hospital Marqués de Valdecilla, Santander, Cantabria, Spain

    Carlos Amado

  8. Department of Clinical Epidemiology and Biostatistics, Research Unit, University Hospital Nuestra Señora de Candelaria Tenerife and Primary Care Management, Santa Cruz de Tenerife, Spain

    Lina I. Pérez-Méndez

  9. Networked Biomedical Research Centre (CIBER) of Respiratory Diseases, Carlos III Health Institute, Madrid, Spain

    Lina I. Pérez-Méndez

  10. Internal Medicine Department, University Hospital Dr Negrín, Las Palmas de Gran Canaria, Spain

    Alicia Conde-Martel

Authors
  1. Ignacio García-Talavera
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  2. Juan Marco Figueira-Gonçalves
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  3. Rafael Golpe
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  4. Cristobal Esteban
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  5. Carlos Amado
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  6. Lina I. Pérez-Méndez
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  7. Amaia Aramburu
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  8. Alicia Conde-Martel
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Contributions

IGT: study design, data collection JM Figueira-Gonçalves: study design, data collection. RG: data interpretation CE: data interpretation CA: data interpretation. AU: literature search LPM: data analysis ACM: manuscript review and editing. All authors contributed equally.

Corresponding author

Correspondence to Ignacio García-Talavera.

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García-Talavera, I., Figueira-Gonçalves, J.M., Golpe, R. et al. Early Desaturation During 6-Minute Walk Test is a Predictor of Mortality in COPD. Lung 201, 217–224 (2023). https://doi.org/10.1007/s00408-023-00613-x

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  • DOI: https://doi.org/10.1007/s00408-023-00613-x

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