To study 6MWT as a prognostic marker in stable COPD patients & its correlation with spirometry grading.
Authors
Sameeksha Shringi
Mahatma Gandhi medical college
Mahesh Kumar Mishra
Mahatma Gandhi Medical College
Aviral Kumar Singh
Mahatma Gandhi Medical College
Keywords:
COPD, 6MWT, Desaturation
Abstract
6MWT is non invasive standardized exercise test that measures global and integrated responses of all systems involved during exercises, including pulmonary and cardiovascular, systemic /peripheral circulation, muscle metabolism. Using desaturation during 6MWT in stable COPD patients we investigated various outcomes-frequency of exacerbations, hospitalizations,mortality & 6MWD correlating with GOLD Grading of spirometry. 110 stable COPD cases were included & followed up for 1 year. Cases were characterized using spirometry grading,smoking profile. The study is designed to identify the relationship of desaturation at baseline using 6MWT with spirometry grading and clinical outcomes of acute exacerbation, hospitalizations and mortality in stable COPD patients which is significantly noted in the study. Materials and Methods: One ten patients with stable COPD diagnosed and staged as per the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines underwent 6MWT. A drop in standard pulse oximetry (SpO 2 ) of ≥4% or nadir up to ≤88% was defined as desaturation. Based on Desaturation during 6MWT, two groups were formed: desaturated cases and nondesaturated cases.Result: Out of 110 stable COPD patients, 36 patients desaturated during 6MWT (n = 36/110). Desaturation was significantly more in higher grades of spirometry (very severe , severe) compared to non desaturated cases. Smokers that too females were significantly more prone for desatuartion probably due to dual signergistic action of bio mass fuel exposure and smoking habits. Rate of hospitalization more frequent in very severe and severe grades with mortality of 5/110 of exclusive very severe grade. Interpretation and Conclusion: The 6MWT is a safe and sensitive test to access prognosis in stable COPD patients. Desaturation during 6 minute walk test is found to be good predictor of hospitalization, exacerbations and mortality.
Author Biographies
Sameeksha Shringi, Mahatma Gandhi medical college
Respiratory Medicine & Senior Resident
Mahesh Kumar Mishra, Mahatma Gandhi Medical College
Respiratory Medicine & Professor & HOD
Aviral Kumar Singh, Mahatma Gandhi Medical College