PMID- 37497382
OWN - NLM
STAT- MEDLINE
DCOM- 20230728
LR  - 20230917
IS  - 1178-2005 (Electronic)
IS  - 1176-9106 (Print)
IS  - 1176-9106 (Linking)
VI  - 18
DP  - 2023
TI  - Prognostic Value of Pace Variability, a Novel 6MWT-Derived Feature, in Patients 
      with Chronic Obstructive Pulmonary Disease.
PG  - 1555-1564
LID - 10.2147/COPD.S407708 [doi]
AB  - PURPOSE: The 6-minute walk test (6MWT) is often used to evaluate chronic 
      obstructive pulmonary disease (COPD) patients' functional capacity, with 6-minute 
      walk distance (6MWD) and related measures being linked to mortality and 
      hospitalizations. This study investigates the prognostic value of pace 
      variability, a significant indicator in sports medicine, during the 6MWT for COPD 
      patients. PATIENTS AND METHODS: We retrospectively screened consecutive COPD 
      patients who had been prospectively enrolled in a pay-for-performance program 
      from January 2019 to May 2020 to determine their eligibility. Patient 
      characteristics, including demographics, exacerbation history, and 6MWT data, 
      were analyzed to investigate their potential associations with prognosis. The 
      primary outcome was a composite of adverse events, including overall mortality or 
      hospitalizations due to exacerbations during a 1-year follow-up period. To 
      analyze the 6MWT data, we divided it into three 2-minute epochs and calculated 
      the average walk speed for each epoch. We defined pace variability as the 
      difference between the maximum and minimum average speed in a single 2-minute 
      epoch, divided by the average speed for the entire 6-minute walk test. RESULTS: A 
      total of 163 patients with COPD were included in the study, and 19 of them (12%) 
      experienced the composite adverse outcome. Multivariable logistic regression 
      analyses revealed that two predictors were independently associated with the 
      composite outcome: % predicted 6MWD <72 (adjusted odds ratio [aOR] 7.080; 95% 
      confidence interval [CI] 1.481-33.847) and pace variability >/=0.39 (aOR 9.444; 95% 
      CI 2.689-33.170). Patients with either of these adverse prognostic features had 
      significantly worse composite outcome-free survival, with both log-rank P values 
      less than 0.005. Notably, COPD patients with both adverse features experienced an 
      especially poor outcome after 1 year. CONCLUSION: Patients with COPD who 
      exhibited greater pace variability during the 6MWT had a significantly higher 
      risk of overall mortality and COPD-related hospitalizations, indicating a worse 
      prognosis.
CI  - (c) 2023 Huang et al.
FAU - Huang, Chun-Ta
AU  - Huang CT
AD  - Department of Internal Medicine, National Taiwan University Hospital, Taipei, 
      Taiwan.
FAU - Ruan, Sheng-Yuan
AU  - Ruan SY
AUID- ORCID: 0000-0002-7949-7253
AD  - Department of Internal Medicine, National Taiwan University Hospital, Taipei, 
      Taiwan.
FAU - Lai, Feipei
AU  - Lai F
AD  - Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan 
      University, Taipei, Taiwan.
AD  - Department of Computer Science & Information Engineering, National Taiwan 
      University, Taipei, Taiwan.
AD  - Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan.
FAU - Chien, Jung-Yien
AU  - Chien JY
AUID- ORCID: 0000-0002-7718-0594
AD  - Department of Internal Medicine, National Taiwan University Hospital, Taipei, 
      Taiwan.
FAU - Yu, Chong-Jen
AU  - Yu CJ
AUID- ORCID: 0000-0001-5664-9392
AD  - Department of Internal Medicine, National Taiwan University Hospital, Taipei, 
      Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20230721
PL  - New Zealand
TA  - Int J Chron Obstruct Pulmon Dis
JT  - International journal of chronic obstructive pulmonary disease
JID - 101273481
SB  - IM
MH  - Humans
MH  - *Pulmonary Disease, Chronic Obstructive
MH  - Prognosis
MH  - Retrospective Studies
MH  - Reimbursement, Incentive
MH  - Walk Test
MH  - Walking
MH  - Exercise Tolerance
PMC - PMC10368117
OTO - NOTNLM
OT  - 6-minute walk test
OT  - chronic obstructive pulmonary disease
OT  - outcome
OT  - pace
OT  - variability
COIS- The authors report no conflicts of interest in this work.
EDAT- 2023/07/27 06:42
MHDA- 2023/07/28 06:42
PMCR- 2023/07/21
CRDT- 2023/07/27 04:29
PHST- 2023/03/28 00:00 [received]
PHST- 2023/07/03 00:00 [accepted]
PHST- 2023/07/28 06:42 [medline]
PHST- 2023/07/27 06:42 [pubmed]
PHST- 2023/07/27 04:29 [entrez]
PHST- 2023/07/21 00:00 [pmc-release]
AID - 407708 [pii]
AID - 10.2147/COPD.S407708 [doi]
PST - epublish
SO  - Int J Chron Obstruct Pulmon Dis. 2023 Jul 21;18:1555-1564. doi: 
      10.2147/COPD.S407708. eCollection 2023.