Oxygen desaturation during a 4-minute step test: predicting survival in idiopathic pulmonary fibrosis

Oxygen desaturation during a 4-minute step test: predicting survival in idiopathic pulmonary fibrosis

Author Stephan, Samia Google Scholar
Pereira, Carlos Alberto de Castro Google Scholar
Coletta, Ester Martins Google Scholar
Ferreira, Rimarcs Gomes Google Scholar
Otta, Jaquelina Sonoe Google Scholar
Nery, Luiz Eduardo Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background and aim: PaO2 during exertion is a significant predictor of IPF survival. The aim of study was to assess oxygen desaturation for predicting survival in IPF patients at the end of a 4-minute step test. Methods: A longitudinal study was done in 59 patients with IPF from February 1998 to January 2005. Upon initial examination, lung function testing was performed, as were 4-minute step tests, in which patients stepped up and down on a 20-cm single step at a self-paced rate. In the final minute, oxygen saturation by pulse oximetry (SpO(2),) was measured. Results: Median survival was 58 months. SpO(2), at rest and during stepping, dyspnea score, as well as FVC% and DLCO% were found to be significant predictors of mortality. Desaturation to 89% or less correlated with a hazard ratio of 2.39 for IPF mortality (95% CI, 1.16-3.63; p < 0.0001). In patients with such desaturation, four-year survival was 39%, compared to 96% in those with no desaturation. In a multivariate Cox analysis, only SPO2 during stepping remained significant (p < 0.0001). A DLCO < 45% of predicted (n=40 patients) correlated with a hazard ratio of 2.23 for mortality (95% CI, 0.73-3.71; p < 0.0001). When the analysis was repeated including DLCO, SPO2 and DLCO remained significant (p < 0.05). Conclusion: Desaturation to 89% or less in a 4-minute step test is a strong predictor of mortality in IPF patients.
Keywords pulmonary fibrosis
oximetry
exercise test
Language English
Date 2007-03-01
Published in Sarcoidosis Vasculitis And Diffuse Lung Diseases. Milano: Fondazione Pneumologia U I P Onlus, v. 24, n. 1, p. 70-76, 2007.
ISSN 1124-0490 (Sherpa/Romeo, impact factor)
Publisher Fondazione Pneumologia U I P Onlus
Extent 70-76
Access rights Closed access
Type Article
Web of Science ID WOS:000251153700009
URI http://repositorio.unifesp.br/11600/45561

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