Department of Medicine, Division of Gastroenterology, Federal University of Juiz de Fora, Juiz de Fora, Brazil. .
Graduate Program on Rehabilitation Sciences, Federal University of Juiz de Fora, Juiz de Fora, Juiz de Fora, Brazil.
J Gastrointestin Liver Dis. 2021 Mar 11;30(1):103-109. doi: 10.15403/jgld-3122.
The 6-minute walk test (6MWT) is a measure of the overall functional capacity and is associated with the risk of mortality in patients with liver cirrhosis and in those listed for liver transplantation. Nevertheless, physical performance has not yet been established as a predictor of the risk of clinical decompensation in patients with cirrhosis. We aimed to determine the capacity of the 6MWT to predict the clinical decompensation in patients with cirrhosis after 1 year of follow-up.
This prospective cohort study included patients with compensated cirrhosis of several etiologies. All participants had stable clinical conditions for at least 6 months prior to baseline. At baseline, patients performed the 6MWT and were followed up for 1 year to detect the decompensation outcomes.
A total of 55 participants completed the evaluation and follow-up. The mean age was 56.3±10.5 years, and 65% were men. Around 65.4% were classified as Child-Pugh class A. In the receiver operating characteristic analysis, a walking distance ≤ 401.8 m during the 6MWT was set as the threshold for predicting clinical decompensation with 64% sensitivity and 82% specificity. Kaplan-Meier curve analysis revealed that patients who covered a distance of < 401.8 m during the test had a decompensation-free outcome rate of 30% as compared to the rate of 75% of those who walked > 401.8 m (p<0.001).
The 6MWT was a significant predictor of clinical decompensation in patients with cirrhosis. A cutoff of 401.8 m was related to an increased risk of clinical decompensation in cirrhotic patients with a stable clinical condition at baseline. The 6MWT should be added to the clinical assessment of the cirrhotic population.
6 分钟步行试验（6MWT）是一种整体功能能力的测量方法，与肝硬化患者的死亡率以及等待肝移植患者的死亡率相关。然而，身体机能尚未被确立为预测肝硬化患者临床失代偿风险的指标。我们旨在确定 6MWT 在预测肝硬化患者 1 年后临床失代偿的能力。
这是一项前瞻性队列研究，纳入了多种病因导致的代偿性肝硬化患者。所有患者在基线时有至少 6 个月的稳定临床状况。在基线时，患者进行了 6MWT 测试，并进行了 1 年的随访，以检测失代偿结局。
共有 55 名患者完成了评估和随访。平均年龄为 56.3±10.5 岁，65%为男性。大约 65.4%的患者被归类为 Child-Pugh 分级 A。在接受者操作特征分析中，6MWT 中行走距离≤401.8 m 被设定为预测临床失代偿的阈值，具有 64%的敏感性和 82%的特异性。Kaplan-Meier 曲线分析显示，在测试中行走距离<401.8 m 的患者无失代偿结局的发生率为 30%，而行走距离>401.8 m 的患者的无失代偿结局发生率为 75%（p<0.001）。
6MWT 是肝硬化患者临床失代偿的显著预测指标。在基线临床状况稳定的肝硬化患者中，401.8 m 的截定点与临床失代偿风险增加相关。6MWT 应被添加到肝硬化人群的临床评估中。
