Highlights
- •There are no data to support recommendation for 6-minute walk test (6MWT) termination if oxyhemoglobin saturation <80%.
- •Retrospective audit of tests was conducted in stable patients by experienced clinicians.
- •A total of 672 tests were reviewed; 2 adverse events were recorded during tests without desaturation.
- •Findings do not support 6MWT termination due to desaturation.
Abstract
Objective
To examine the occurrence of adverse events in patients undergoing assessment for
pulmonary rehabilitation when a 6-minute walk test (6MWT) continues despite desaturation
below 80%.
Design
Retrospective audit following REporting of studies Conducted using Observational Routinely-collected
health Data (RECORD) Statement.
Setting
Large teaching hospital.
Participants
All patients (N=549) (55% men, mean age 69±11y) assessed for pulmonary rehabilitation
(September 2005 to January 2016).
Interventions
The standardized tests were conducted by experienced cardiorespiratory physiotherapists.
Oxyhemoglobin saturation was monitored continuously using a pulse oximeter (lowest
value used for analysis). Medical records were reviewed, and adverse events defined
as tachycardia, bradycardia, chest pain, or other sign/symptom necessitating cessation.
Main Outcome Measure
6MWT.
Results
Data from 672 walk tests were included with mean distance 369 (124) meters. The main
diagnoses were chronic obstructive pulmonary disease (70%), interstitial lung disease
(14%), and bronchiectasis (8%). Sixty individuals (11%) recorded desaturation below
80% without adverse events. Two adverse events were recorded during tests without
desaturation; in 1 instance, chest pain with no evidence of cardiorespiratory compromise
and in another, the patient stopped due to concern regarding blood sugar levels (11.5
mmol/L when tested). Independent predictors of desaturation to less than 80% were
resting oxyhemoglobin saturation <95% (odds ratio [OR] 3.82, 95% confidence interval
[CI] 2.06-7.08) and a diagnosis of interstitial lung disease or pulmonary arterial
hypertension (OR 5.24, 95% CI 2.59-10.58).
Conclusions
This study found that desaturation to less than 80% during a 6MWT was not associated
with adverse events in a large cohort of patients referred to pulmonary rehabilitation
and assessed by experienced physiotherapists, suggesting that test cessation due to
desaturation in stable patients may be unwarranted.
Keywords
List of abbreviations:
6MWT (6-minute walk test), 6MWD (6-minute walk distance), CI (confidence interval), OR (odds ratio), RECORD (REporting of studies Conducted using Observational Routinely-collected health Data), SpO2 (oxyhemoglobin saturation)To read this article in full you will need to make a payment
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References
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Article info
Publication history
Published online: August 18, 2018
Footnotes
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
