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Oxygen desaturation during a 4-minute step test: predicting survival in idiopathic pulmonary fibrosis.
Stephan, Samia; de Castro Pereira, Carlos Alberto; Coletta, Ester Martins; Ferreira, Rimarcs Gomes; Otta, Jaquelina Sonoe; Nery, Luiz Eduardo.
Afiliação
  • Stephan S; Pulmonary Department, Federal University of São Paulo, Brazil.
Sarcoidosis Vasc Diffuse Lung Dis ; 24(1): 70-6, 2007 Mar.
Article em En | MEDLINE | ID: mdl-18069422
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 (SpO2) was measured. RESULTS: Median survival was 58 months. SpO2 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-min step test is a strong predictor of mortality in IPF patients.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Oxigênio / Fibrose Pulmonar / Teste de Esforço Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Sarcoidosis Vasc Diffuse Lung Dis Assunto da revista: ALERGIA E IMUNOLOGIA / ANGIOLOGIA Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Brasil País de publicação: Itália
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Oxigênio / Fibrose Pulmonar / Teste de Esforço Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Sarcoidosis Vasc Diffuse Lung Dis Assunto da revista: ALERGIA E IMUNOLOGIA / ANGIOLOGIA Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Brasil País de publicação: Itália