Kumar Ankit, Hegde Naveen, Kumaravel J, Mohindra Ritin, Soni Roop Kishor, Rathod Ramya, Kumar Mohan, Muthu Valliappan, Gamad Nanda, Patil Amol N, Sharma P L
Department of Pharmacology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
J Family Med Prim Care. 2022 Nov;11(11):7008-7014. doi: 10.4103/jfmpc.jfmpc_1111_22. Epub 2022 Dec 16.
There has been a lack of uniformity on how to triage coronavirus disease 2019 (COVID-19) patients visiting the emergency units of hospitals. Triage tools are themselves spreading the pandemic in hospital areas. The present study compared a master two-step (M2ST) exercise stress test versus a 6-min walk test (6MWT) in COVID-19-positive patients visiting the emergency unit of a hospital.
Thirty-nine patients underwent 6MWT followed by M2ST, while another set of 38 patients underwent M2ST followed by 6MWT in this randomized, crossover, open-label, and noninferiority study. The exercise tests assessed the change from baseline in SpO, heart rate (HR), respiratory rate, blood pressure, exertion, and dyspnea on the modified-Borg scale.
Noninferiority was established for SpO ( < 0.05), systolic blood pressure (SBP; < 0.001), and diastolic blood pressure (DBP; < 0.05), but not for HR ( = 0.3) and respiratory rate ( = 0.6). The difference between the pretest and posttest (delta change) values for the parameters SpO, respiratory rate, HR, SBP, and DBP correlated significantly ( < 0.001) with Pearson correlation coefficient ( = 0.764, 0.783, 0.473, 0.838, and 0.783, respectively). The delta change values of modified-Borg scale for dyspnea ( = 0.291) and exertion ( = 0.208) were statistically insignificant between the two exercise tests. However, the correlation between the tests was statistically significant ( < 0.001).
M2ST, a timesaving, cost-effective, and easy to perform exercise stress test, has been identified as a reliable alternative for 6MWT.
对于前往医院急诊科的2019冠状病毒病(COVID-19)患者,在如何进行分诊方面缺乏统一标准。分诊工具本身正在医院区域传播这种大流行病。本研究比较了在一家医院急诊科就诊的COVID-19阳性患者中,主两步(M2ST)运动应激试验与6分钟步行试验(6MWT)。
在这项随机、交叉、开放标签且非劣效性研究中,39名患者先进行6MWT,然后进行M2ST,而另一组38名患者先进行M2ST,然后进行6MWT。运动试验评估了在改良Borg量表上,从基线开始的血氧饱和度(SpO)、心率(HR)、呼吸频率、血压、用力程度和呼吸困难的变化。
在SpO(<0.05)、收缩压(SBP;<0.001)和舒张压(DBP;<0.05)方面确立了非劣效性,但在HR(=0.3)和呼吸频率(=0.6)方面未确立。SpO、呼吸频率、HR、SBP和DBP参数的测试前与测试后(差值变化)值之间的差异与Pearson相关系数显著相关(<0.001)(分别为=0.764、0.783、0.473、0.838和0.783)。在两项运动试验之间,改良Borg量表上呼吸困难(=0.291)和用力程度(=0.208)的差值变化值无统计学意义。然而,两项试验之间的相关性具有统计学意义(<0.001)。
M2ST是一种省时、经济高效且易于实施的运动应激试验,已被确定为6MWT的可靠替代方法。