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Published ahead of print on August 13, 2003, doi:10.1164/rccm.200302-219OC
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American Journal of Respiratory and Critical Care Medicine Vol 168. pp. 1084-1090, (2003)
© 2003 American Thoracic Society

Prognostic Value of Desaturation during a 6-Minute Walk Test in Idiopathic Interstitial Pneumonia

Vibha N. Lama, Kevin R. Flaherty, Galen B. Toews, Thomas V. Colby, William D. Travis, Qi Long, Susan Murray, Ella A. Kazerooni, Barry H. Gross, Joseph P. Lynch, III and Fernando J. Martinez

Division of Pulmonary and Critical Care Medicine and Department of Radiology, University of Michigan Health System; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan; and the Armed Forces Institute of Pathology, Mayo Clinic, Scottsdale, Arizona

Correspondence and requests for reprints should be addressed to Fernando J. Martinez, M.D., M.S., 1500 East Medical Center Drive, 3916 Taubman Center, Ann Arbor, MI 48109–0360. E-mail: fmartine{at}umich.edu

Exercise-induced hypoxia is an index of the severity of interstitial lung disease. We hypothesized that desaturation during a 6-minute walk test would predict mortality for patients with usual interstitial pneumonia (n = 83) and nonspecific interstitial pneumonia (n = 22). Consecutive patients with biopsy-proven disease performed a 6-minute walk test between January 1996 and December 2001. Desaturation was defined as a fall in oxygen saturation to 88% or less during the 6-minute walk test. Desaturation was common (44 of 83 usual interstitial pneumonia and 8 of 22 nonspecific interstitial pneumonia; chi square, p = 0.39). Patients with usual interstitial pneumonia or nonspecific interstitial pneumonia who desaturated had a significantly higher mortality than patients who did not desaturate (respective log-rank tests, p = 0.0018, p = 0.0089). In patients with usual interstitial pneumonia, the presence of desaturation was associated with an increased hazard of death (hazard ratio, 4.2; 95% confidence interval, 1.40, 12.56; p = 0.01) after adjusting for age, sex, smoking, baseline diffusion capacity for carbon monoxide, FVC, and resting saturation. We conclude that knowledge of desaturation during a 6-minute walk test adds prognostic information for patients with usual interstitial pneumonia and nonspecific interstitial pneumonia.

Key Words: 6-minute walk test • usual interstitial pneumonia • nonspecific interstitial pneumonia




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