Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City 833, Taiwan.
Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City 833, Taiwan.
Medicina (Kaunas). 2023 Feb 17;59(2):391. doi: 10.3390/medicina59020391.
Exertional desaturation (ED) is common and is associated with poorer clinical outcomes in chronic obstructive pulmonary disease (COPD). The age, dyspnea, airflow obstruction (ADO) and body mass index, airflow obstruction, dyspnea, and exercise (BODE) indexes are used to predict the prognosis of COPD patients. This study aimed to investigate the relationship between these indexes, pulmonary function, medical costs, and ED in COPD patients. Data were collected from the electronic database of the Kaohsiung Chang Gung Memorial Hospital. This retrospective study included 396 patients categorized as either ED = 231) or non-ED ( = 165). Variables (including age, smoking history, body mass index (BMI), pulmonary function test, maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), six minutes walking test distance (6MWD), SpO, COPD Assessment Test (CAT) score, ADO index, BODE index, Charlson comorbidity index (CCI), and medical costs) were compared between the two groups, and their correlations were assessed. ED was defined as SpO less than 90% or SpO decrease of more than 4% compared to baseline levels during 6MWT. A significant statistical difference was found regarding a lower score of the ADO index and the BODE index (both < 0.001), better pulmonary function (forced expiratory volume in the first second (FEV1), < 0.001; FEV1/ forced vital capacity (FVC), < 0.001; diffusion capacity of the lung for carbon monoxide (DLCO), < 0.001), and higher minimal oxygen saturation ( < 0.001) in non-ED COPD patients. No difference was found in the distance of the 6MWT ( = 0.825) and respiratory muscle strength (MIP; MEP, = 0.86; 0.751). However, the adjusted multivariate logistic regression analysis showed that only SpO (minimal) had a significant difference between of the ED and non-ED group ( < 0.001). There was either no difference in the medical expenses between ED and non-ED COPD patients. SpO (minimal) during the 6MWT is the independent factor for ED. ED is related to BODE and ADO indices, but is not related to medical expense.
运动性低氧血症（ED）在慢性阻塞性肺疾病（COPD）中很常见，与较差的临床结局相关。年龄、呼吸困难、气流阻塞（ADO）和体重指数、气流阻塞、呼吸困难和运动（BODE）指数用于预测 COPD 患者的预后。本研究旨在探讨这些指标、肺功能、医疗费用与 COPD 患者 ED 之间的关系。数据来自高雄长庚纪念医院的电子数据库。这项回顾性研究包括 396 名患者，分为 ED 组（n=231）和非 ED 组（n=165）。比较两组之间的变量（包括年龄、吸烟史、体重指数（BMI）、肺功能检查、最大吸气压力（MIP）和最大呼气压力（MEP）、6 分钟步行试验距离（6MWD）、SpO、COPD 评估测试（CAT）评分、ADO 指数、BODE 指数、Charlson 合并症指数（CCI）和医疗费用），并评估它们之间的相关性。ED 定义为 6MWT 期间 SpO 低于 90%或与基线相比下降超过 4%。非 ED COPD 患者的 ADO 指数和 BODE 指数评分较低（均<0.001）、肺功能较好（第一秒用力呼气量（FEV1），<0.001；FEV1/用力肺活量（FVC），<0.001；一氧化碳弥散量（DLCO），<0.001）和最低氧饱和度较高（<0.001），差异有统计学意义。6MWT 距离（=0.825）和呼吸肌力量（MIP；MEP，=0.86；0.751）无差异。然而，调整后的多变量逻辑回归分析显示，只有 SpO（最低）在 ED 和非 ED 组之间有显著差异（<0.001）。ED 和非 ED COPD 患者的医疗费用无差异。6MWT 期间的 SpO（最低）是 ED 的独立因素。ED 与 BODE 和 ADO 指数相关，但与医疗费用无关。
