Exertional desaturation as a predictor of rapid lung function decline in COPD.
Kim, C; Seo, JB; Lee, SM; Lee, JS; Huh, JW; Lee, JH; Ra, SW; Kim, EK; Kim, TH; Kim, WJ; Lee, SY; Lim, SY; Shin, TR; Yoon, HI; Sheen, SS; Oh, YM; Park, YB; Lee, SD
Respiration: international review of thoracic diseases, 86(2):109-116, 2013
Respiration: international review of thoracic diseases
BACKGROUND: To date, no clinical parameter has been associated with the decline in lung function other than emphysema severity in COPD.
OBJECTIVES: The main purpose of this study was to explore whether the rate of lung function decline differs between COPD patients with and without exertional desaturation.
METHODS: A total of 224 subjects were selected from the Korean Obstructive Lung Disease cohort. Exertional desaturation was assessed using the 6-min walk test (6MWT), and defined as a post-exercise oxygen saturation (SpO2) of < 90% or a ≥ 4% decrease. The cohort was divided into desaturator (n = 47) and non-desaturator (n = 177) groups.
RESULTS: There was a significant difference between the desaturator and non-desaturator groups in terms of the change in pre-bronchodilator forced expiratory volume in 1 s (FEV1) over a 3-year period of follow-up (p = 0.006). The mean rate of decline in FEV1 was greater in the desaturator group (33.8 ml/year) than in the non-desaturator group (11.6 ml/year). A statistically significant difference was also observed between the two groups in terms of the change in the St. George's Respiratory Questionnaire (SGRQ) total score over 3 years (p = 0.001).
CONCLUSIONS: This study suggests, for the first time, that exertional desaturation may be a predictor of rapid decline in lung function in patients with COPD. The 6MWT may be a useful test to predict a rapid lung function decline in COPD.
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