Abstract
BACKGROUND: Oxygen desaturation during walking can have important consequence on prognosis of COPD patients. However, a standard 6-min walk test (6MWT), useful in detecting desaturation in COPD patients, can be difficult to execute in some settings of COPD management, as in the community healthcare service. We evaluated a new scoring system for the risk of oxygen desaturation during walking in COPD patients: the walking desaturation score. METHODS: We collected data from symptomatic COPD in-patients admitted for rehabilitation (derivation cohort) and out-patients referred to the local community health service (validation cohort). SpO2 was monitored during 6MWT, and the subjects were classified as walking desaturators or non-desaturators. By a regression analysis model we assigned a weighted score proportional to the measured percentage of explained variance for each variable. Risk estimates were computed as odds ratios. A receiver operating characteristic curve analysis and a Hosmer-Lemeshow goodness-of-fit test were then performed to measure discrimination and calibration of walking desaturation score. RESULTS: Baseline characteristics in the derivation cohort (n= 435, 74% of whom were walking desaturators) and the validation cohort (n =238, 37% of whom were walking desaturators) were different. Resting arterial oxygen saturation measured from an arterial blood sample, PaO2, and percent-of-predicted FEV1 were the variables that predicted walking desaturation. The proportion of walking desaturators (and odds ratio estimate) gradually increased according to walking desaturation score (range 0-6) and associated categories of desaturation risk (total walking desaturation score: low 0 or 1, high 2-3, very high 4-6) (chi-square P
| Original language | English |
|---|---|
| Pages (from-to) | 1495-1503 |
| Number of pages | 9 |
| Journal | Respiratory Care |
| Volume | 58 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - Sep 1 2013 |
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Keywords
- 6-min walk test
- Community healthcare
- COPD
- Decision making
- Oxygen desaturation
- Risk score
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
Cite this
Predicting walking-induced oxygen desaturations in COPD patients : A statistical model. / Crisafulli, Ernesto; Iattoni, Andrea; Venturelli, Elena; Siscaro, Gherardo; Beneventi, Claudio; Cesario, Alfredo; Clini, Enrico M.
In: Respiratory Care, Vol. 58, No. 9, 01.09.2013, p. 1495-1503.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predicting walking-induced oxygen desaturations in COPD patients
T2 - A statistical model
AU - Crisafulli, Ernesto
AU - Iattoni, Andrea
AU - Venturelli, Elena
AU - Siscaro, Gherardo
AU - Beneventi, Claudio
AU - Cesario, Alfredo
AU - Clini, Enrico M.
PY - 2013/9/1
Y1 - 2013/9/1
N2 - BACKGROUND: Oxygen desaturation during walking can have important consequence on prognosis of COPD patients. However, a standard 6-min walk test (6MWT), useful in detecting desaturation in COPD patients, can be difficult to execute in some settings of COPD management, as in the community healthcare service. We evaluated a new scoring system for the risk of oxygen desaturation during walking in COPD patients: the walking desaturation score. METHODS: We collected data from symptomatic COPD in-patients admitted for rehabilitation (derivation cohort) and out-patients referred to the local community health service (validation cohort). SpO2 was monitored during 6MWT, and the subjects were classified as walking desaturators or non-desaturators. By a regression analysis model we assigned a weighted score proportional to the measured percentage of explained variance for each variable. Risk estimates were computed as odds ratios. A receiver operating characteristic curve analysis and a Hosmer-Lemeshow goodness-of-fit test were then performed to measure discrimination and calibration of walking desaturation score. RESULTS: Baseline characteristics in the derivation cohort (n= 435, 74% of whom were walking desaturators) and the validation cohort (n =238, 37% of whom were walking desaturators) were different. Resting arterial oxygen saturation measured from an arterial blood sample, PaO2, and percent-of-predicted FEV1 were the variables that predicted walking desaturation. The proportion of walking desaturators (and odds ratio estimate) gradually increased according to walking desaturation score (range 0-6) and associated categories of desaturation risk (total walking desaturation score: low 0 or 1, high 2-3, very high 4-6) (chi-square P
AB - BACKGROUND: Oxygen desaturation during walking can have important consequence on prognosis of COPD patients. However, a standard 6-min walk test (6MWT), useful in detecting desaturation in COPD patients, can be difficult to execute in some settings of COPD management, as in the community healthcare service. We evaluated a new scoring system for the risk of oxygen desaturation during walking in COPD patients: the walking desaturation score. METHODS: We collected data from symptomatic COPD in-patients admitted for rehabilitation (derivation cohort) and out-patients referred to the local community health service (validation cohort). SpO2 was monitored during 6MWT, and the subjects were classified as walking desaturators or non-desaturators. By a regression analysis model we assigned a weighted score proportional to the measured percentage of explained variance for each variable. Risk estimates were computed as odds ratios. A receiver operating characteristic curve analysis and a Hosmer-Lemeshow goodness-of-fit test were then performed to measure discrimination and calibration of walking desaturation score. RESULTS: Baseline characteristics in the derivation cohort (n= 435, 74% of whom were walking desaturators) and the validation cohort (n =238, 37% of whom were walking desaturators) were different. Resting arterial oxygen saturation measured from an arterial blood sample, PaO2, and percent-of-predicted FEV1 were the variables that predicted walking desaturation. The proportion of walking desaturators (and odds ratio estimate) gradually increased according to walking desaturation score (range 0-6) and associated categories of desaturation risk (total walking desaturation score: low 0 or 1, high 2-3, very high 4-6) (chi-square P
KW - 6-min walk test
KW - Community healthcare
KW - COPD
KW - Decision making
KW - Oxygen desaturation
KW - Risk score
UR - http://www.scopus.com/inward/record.url?scp=84883306797&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883306797&partnerID=8YFLogxK
U2 - 10.4187/respcare.02321
DO - 10.4187/respcare.02321
M3 - Article
C2 - 23362168
AN - SCOPUS:84883306797
VL - 58
SP - 1495
EP - 1503
JO - Respiratory Care
JF - Respiratory Care
SN - 0020-1324
IS - 9
ER -