The distance-saturation product predicts mortality in idiopathic pulmonary fibrosis

Lettieri, Christopher J.; Nathan, Steven D.; Browning, Robert; Barnett, Scott D.; Ahmad, Shahzad; Shorr, Andrew F.

doi:10.1016/j.rmed.2006.02.004

Cited by 141 publications

(160 citation statements)

References 27 publications

(48 reference statements)

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“…The distance-saturation product (DSP, m%), which included surveillance of both the walking distance and lowest oxygen saturation of patients during 6MWT, may be a predictive factor of worsening condition and survival of patients with idiopathic pulmonary fibrosis (13).…”

Section: Original Articlementioning

confidence: 99%

“…Variables from 6MWT, including pulmonary spirometry, BODE (body-mass index, airflow obstruction, dyspnea, and exercise) index, EID, and DSP, were recorded. DSP was defined as the product of the final 6-minute walk distance (6MWD) in meters and the lowest oxygen saturation in room air during 6MWT (EID) (13). For example, a patient walking a total of 300 m with a lowest oxygen saturation of 88% during 6MWT would have a DSP of 264 m% (e.g., 300×0.88).…”

Section: Mwtmentioning

confidence: 99%

“…The application of DSP in patients with a variety of chronic lung diseases has been reported (13,20,26). Lettieri et al found that DSP provides a novel measurement with slightly better accuracy than other parameters to predict survival of patients with idiopathic pulmonary fibrosis (13).…”

Section: Correlations Between 6mwt-derived Variables and 6-year Survivalmentioning

confidence: 99%

“…Lettieri et al found that DSP provides a novel measurement with slightly better accuracy than other parameters to predict survival of patients with idiopathic pulmonary fibrosis (13). In patients with sarcoidosis, Bourbonnais et al reported that DSP is an easily calculated clinical parameter to predict healthrelated quality of life over time and for intervention (26).…”

Section: Correlations Between 6mwt-derived Variables and 6-year Survivalmentioning

confidence: 99%

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Distance-saturation product of the 6-minute walk test predicts mortality of patients with non-cystic fibrosis bronchiectasis

et al. 2017

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Background: Previous surveillance methods to monitor the prognoses of patients with bronchiectasis are too complex for use in daily practice. The 6-minute walk test (6MWT) is a simple exercise test to predict the prognosis of chronic obstructive airway disease and numerous chronic lung diseases, including idiopathic pulmonary fibrosis. No studies have investigated exercise-induced oxygen desaturation (EID) and distancesaturation product (DSP) of 6MWT to predict the prognoses of patients with bronchiectasis. Methods: This was a prospective study to identify correlations between variables of 6MWT and mortality in patients with bronchiectasis over a 6-year period. The study cohort included 69 patients with stable noncystic fibrosis (non-CF) bronchiectasis who were regularly evaluated for functional status via 6-minute walk distance (6MWD), spirometry, BODE index, EID, and DSP.Results: Of the 69 patients, 9 (13%) died and 60 (87%) survived during the 6-year follow-up period. Multivariate analysis showed that DSP (OR =0.983; P=0.001) was the best parameter of 6MWT to predict mortality. Patients with a lower DSP of <280 m% were at a 66.5-fold greater risk (OR =66.5; 95% CI: 9.4-469.2) of 6-year mortality compared with those with DSP >280 m% (P<0.001).Conclusions: DSP is a simple parameter to predict 6-year mortality in patients with non-CF bronchiectasis.

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Section: Original Articlementioning

confidence: 99%

Section: Mwtmentioning

confidence: 99%

Section: Correlations Between 6mwt-derived Variables and 6-year Survivalmentioning

confidence: 99%

Section: Correlations Between 6mwt-derived Variables and 6-year Survivalmentioning

confidence: 99%

See 2 more Smart Citations

Distance-saturation product of the 6-minute walk test predicts mortality of patients with non-cystic fibrosis bronchiectasis

et al. 2017

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“…22,23 The 6-min walk test is a very sensitive test that is used to detect oxygen desaturation 24 and to determine the oxygen flow necessary to correct exercise-induced desaturation. 25 Exercise desaturation in patients with emphysema and normoxia at rest has been associated with poor prognosis, although it remains to be seen whether oxygen therapy improves survival in those patients.…”

Section: Limitationsmentioning

confidence: 99%

Time to Desaturation Less Than One Minute Predicts the Need for Long-Term Home Oxygen Therapy

et al. 2011

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BACKGROUND: Exercise desaturation in patients with COPD is a pathophysiological phenomenon that is not wholly understood and whose clinical consequences are still unclear. METHODS: Eighty-three patients with moderate to severe COPD and P aO 2 > 60 mm Hg who desaturated during the 6-min walk test were followed for 5 years. Forty-eight patients had early desaturation (S pO 2 fell below 90% less than one minute after starting the walk test). Spirometry, blood-gas measurements, and 6-min walk tests were performed every 6 months. We recorded 6-min walk distance, baseline S pO 2 , lowest S pO 2 , and the time to S pO 2 < 90%. In each control, stable patients with severe hypoxia at rest who required long-term oxygen therapy were identified. RESULTS: Upon completion of the study, 65% of the early desaturators had developed severe hypoxemia and required long-term home oxygen, versus 11% in the non-early desaturators (P < .001). CONCLUSIONS: In patients with moderate to severe COPD, desaturation within the first minute of the 6-min walk test predicts the need for long-term home oxygen at 5-year follow-up.

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Pulmonary hypertension in patients with interstitial lung disease: a tool for early detection

et al. 2022

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Pulmonary hypertension (PH) complicates the treatment of interstitial lung disease (ILD) patients resulting in poor functional status and worse outcomes. Early recognition of PH in ILD is important for initiating therapy and considering lung transplantation. However, no standard exists regarding which patients to screen for PH‐ILD or the optimal method to do so. The aim of this study was to create a risk assessment tool that could reliably predict PH in ILD patients. We developed a PH‐ILD Detection tool that incorporated history, exam, 6‐min walk distance, diffusion capacity for carbon monoxide, chest imaging, and cardiac biomarkers to create an eight‐component score. This tool was analyzed retrospectively in 154 ILD patients where each patient was given a score ranging from 0 to 12. The sensitivity (SN) and specificity (SP) of the PH‐ILD Detection tool and an area‐under‐the‐curve (AUC) were calculated. In this cohort, 74 patients (48.1%) had PH‐ILD. A score of ≥6 on the PH‐ILD Detection tool was associated with a diagnosis of PH‐ILD (SN: 86.5%; SP: 86.3%; area‐under‐the‐curve: 0.920, p < 0.001). The PH‐ILD Detection tool provides high SN and SP for detecting PH in ILD patients. With confirmation in larger cohorts, this tool could improve the diagnosis of PH in ILD and may suggest further testing with right heart catheterization and earlier intervention with inhaled treprostinil and/or lung transplant evaluation.

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The distance-saturation product predicts mortality in idiopathic pulmonary fibrosis

Abstract: 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.

Cited by 141 publications

References 27 publications

Distance-saturation product of the 6-minute walk test predicts mortality of patients with non-cystic fibrosis bronchiectasis

Distance-saturation product of the 6-minute walk test predicts mortality of patients with non-cystic fibrosis bronchiectasis

Time to Desaturation Less Than One Minute Predicts the Need for Long-Term Home Oxygen Therapy

Pulmonary hypertension in patients with interstitial lung disease: a tool for early detection

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