The distance-saturation product predicts mortality in idiopathic pulmonary fibrosis
The distance-saturation product predicts mortality in idiopathic pulmonary fibrosis
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DOI：
10.1016/j.rmed.2006.02.004
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发表时间：
2006-10-01
影响因子：
4.3
通讯作者：
Shorr, Andrew F.
中科院分区：
文献类型：
--
作者：
Lettieri, Christopher J.;Nathan, Steven D.;Shorr, Andrew F.
6分钟步行试验（6MWT）在包括特发性肺纤维化（IPF）在内的各种肺部疾病中具有预后价值。我们确定了IPF患者6MWT期间步行距离和血氧饱和度的个体预后准确性。我们定义了一个新的复合指数，即步行距离和最低血氧饱和度的乘积（DSP）。我们比较了DSP与单个6MWT参数在预测死亡率方面的性能。方法：我们评估幸存者和非幸存者之间的肺功能测试、6分钟步行参数和DSP。每个测量区分结果的能力由接收算子曲线决定。结果：纳入81例患者（48例幸存者，33例非幸存者）。肺功能测试结果相似，与生存率无关。非幸存者的去饱和度更高（89.4%比83.7%,P < 0.001），步行距离更低（406.9比181.3 m, P = 0.005）。非幸存者的DSP明显较低（364.8 vs 153.5 m%, P < 0.001），并且比任何一个单独的6MWT分量更准确地预测死亡率（P = 0.035 vs去饱和，P = 0.040 vs距离）。与DSP < 200m %的患者相比，DSP < 200m %的患者12个月死亡风险增加7倍，中位生存期缩短18.0% （P < 0.001）。讨论：6分钟步行的每个组成部分独立预测IPF的死亡率比肺活量测定法更准确。然而，这两个参数的组合，即DSP，提供了更高的准确性，并代表了评估IPF患者生存的新措施。Elsevier Ltd.出版。
Introduction: The 6-min walk test (6MWT) has prognostic value in various pulmonary disorders including idiopathic pulmonary fibrosis (IPF). We determined the individual prognostic accuracy of distance walked and oxygen saturation during the 6MWT in patients with IPF We defined a new composite index, the distance-saturation product (DSP), which is the product of distance walked and Lowest oxygen saturation during the 6-min walk test. We compared the performance of the DSP to the individual 6MWT parameters in predicting mortality.Methods: We evaluated pulmonary function tests, 6-min walk parameters and the DSP between survivors and non-survivors. The ability of each measure to discriminate outcomes was determined by receiver operator curves.Results: 81 patients (48 survivors, 33 non-survivors) were included. Pulmonary function tests were similar and did not correlate with survival. Desaturation was greater (89.4% versus 83.7%, P < 0.001) and distance walked was lower (406.9 versus 181.3 m, P = 0.005) in non-survivors. The DSP was significantly lower among non-survivors (364.8 versus 153.5 m%, P < 0.001) and predicted mortality more accurately than either individual 6MWT component (P = 0.035 versus desaturation, P = 0.040 versus distance). A DSP < 200 m% was associated with a seven-fold greater risk of 12-month mortality and an 18.0% shorter median survival compared with a DSP > 200 m% (P < 0.001).Discussion: Each component of the 6-min walk independently predicted mortality in IPF with greater accuracy than spirometry. However, a composite of both parameters, the DSP, provides slightly greater accuracy and represents a novel measure for assessing survival in patients with IPF. Published by Elsevier Ltd.