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  • Title: Exertional desaturation as a predictor of rapid lung function decline in COPD.
    Author: Kim C, Seo JB, Lee SM, Lee JS, Huh JW, Lee JH, Ra SW, Lee JH, Kim EK, Kim TH, Kim WJ, Lee SM, Lee SY, Lim SY, Shin TR, Yoon HI, Sheen SS, Oh YM, Park YB, Lee SD.
    Journal: Respiration; 2013; 86(2):109-16. PubMed ID: 23235126.
    Abstract:
    BACKGROUND: To date, no clinical parameter has been associated with the decline in lung function other than emphysema severity in COPD. OBJECTIVES: The main purpose of this study was to explore whether the rate of lung function decline differs between COPD patients with and without exertional desaturation. METHODS: A total of 224 subjects were selected from the Korean Obstructive Lung Disease cohort. Exertional desaturation was assessed using the 6-min walk test (6MWT), and defined as a post-exercise oxygen saturation (SpO2) of < 90% or a ≥ 4% decrease. The cohort was divided into desaturator (n = 47) and non-desaturator (n = 177) groups. RESULTS: There was a significant difference between the desaturator and non-desaturator groups in terms of the change in pre-bronchodilator forced expiratory volume in 1 s (FEV1) over a 3-year period of follow-up (p = 0.006). The mean rate of decline in FEV1 was greater in the desaturator group (33.8 ml/year) than in the non-desaturator group (11.6 ml/year). A statistically significant difference was also observed between the two groups in terms of the change in the St. George's Respiratory Questionnaire (SGRQ) total score over 3 years (p = 0.001). CONCLUSIONS: This study suggests, for the first time, that exertional desaturation may be a predictor of rapid decline in lung function in patients with COPD. The 6MWT may be a useful test to predict a rapid lung function decline in COPD.
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