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6分钟步行距离对等待肺移植患者生存的预测效用

Predictive utility of the 6-minute walk distance on survival in patients awaiting lung transplantation.

作者信息

Tuppin Michael Patrick, Paratz Jennifer D, Chang Angela T, Seale Helen E, Walsh James R, Kermeeen Fiona D, McNeil Keith D, Hopkins Peter M

机构信息

Queensland Heart and Lung Transplant Unit, Prince Charles Hospital, University of Queensland, Brisbane, Queensland, Australia.

出版信息

J Heart Lung Transplant. 2008 Jul;27(7):729-34. doi: 10.1016/j.healun.2008.03.017. Epub 2008 May 19.

Abstract

BACKGROUND

The 6-minute walk distance (6MWD) is a widely used clinical indicator of exercise capacity. Although used as part of the assessment process in determining a candidate's suitability for lung transplantation (LT), the literature describing the impact of the 6MWD in predicting survival on LT waiting lists is limited. This study aimed to determine the hazard function associated with the 6MWD, and its utility relative to other prognostic variables.

METHODS

A retrospective chart review was conducted on 163 patients who were listed for single or double LT, and either survived to transplant or died while on the waiting list. A Cox regression for survival analysis, stratified by diagnostic group, was conducted utilizing the 6MWD, demographic variables and measures of cardiopulmonary function.

RESULTS

The 6MWD proved to be the only significant covariate in the Cox regression for survival analysis (p < 0.001), with all other variables eliminated as non-significant. Furthermore, there was a protective effect for each unit increase in the 6MWD [Exp (B) = 0.994, 95% confidence interval 0.990 to 0.997].

CONCLUSIONS

This research demonstrates that the 6MWD is useful for stratifying patients on the LT waiting list by identifying those patients with a significantly higher risk of mortality.

摘要

背景

6分钟步行距离(6MWD)是一种广泛应用的运动能力临床指标。尽管它被用作评估肺移植(LT)候选人适用性的评估过程的一部分,但描述6MWD对LT等待名单上生存率预测影响的文献有限。本研究旨在确定与6MWD相关的风险函数及其相对于其他预后变量的效用。

方法

对163名单肺或双肺LT候选人进行回顾性病历审查,这些候选人要么存活至移植,要么在等待名单上死亡。利用6MWD、人口统计学变量和心肺功能指标,进行按诊断组分层的生存分析Cox回归。

结果

6MWD被证明是生存分析Cox回归中唯一显著的协变量(p < 0.001),所有其他变量因不显著而被排除。此外,6MWD每增加一个单位都有保护作用[Exp (B) = 0.994,95%置信区间0.990至0.997]。

结论

本研究表明,6MWD通过识别死亡率显著较高的患者,有助于对LT等待名单上的患者进行分层。

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