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

Changhwan Kim, Yousang Ko, Jae Seung Lee, Chin Kook Rhee, Jin Hwa Lee, Ji Yong Moon, Seong Yong Lim, Kwang Ha Yoo, Joon Beom Seo, Yeon Mok Oh, Sang Do Lee, Yong Bum Park

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2 Scopus citations

Abstract

Background: 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.

Original languageEnglish
Article number106393
JournalRespiratory Medicine
Volume182
DOIs
StatePublished - Jun 2021

Keywords

  • Chronic obstructive pulmonary disease
  • Exercise-induced desaturation
  • Mortality

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