Six-minute walk distance and dyspnoea scores to assess the course of COPD exacerbation in elderly patients
Author and contributionship
Thomas Blankenburg designed this investigation and wrote the manuscript. Anne Guettel collected and analysed the data. Christian Busch recruited patients, reviewed the manuscript. Wolfgang Schuette designed this investigation, reviewed the manuscript.
This clinical trial has been reviewed and approved by the local ethical committee and patients gave informed consent prior to the inclusion of the study. It complies with the principles laid down in the Declaration of Helsinki; recommendations guiding physicians in biomedical research involving human subjects.
Conflict of interest
The authors have stated explicitly that there are no conflicts of interest in connection with this article.
Thomas Blankenburg, MD, Hospital Martha-Maria Halle-Doelau, Second Medical Clinic, Roentgenstr. 1, D-06120 Halle/Saale, Germany.
Tel: +49 345 559 1440
Fax: +49 345 559 1442
While the severity of stable chronic obstructive pulmonary disease (COPD) has been defined in a valid and relevant prognostic manner, parameters that describe the course of COPD exacerbations are not yet established. Physical performance and dyspnoea are of prognostic relevance in stable COPD. The issue investigated was to assess the course of COPD exacerbations to find parameters that describe this situation better.
In 82 hospitalised patients with acute exacerbation of COPD who responded to intensified medical treatment (age 67.3 ± 9.5 years; forced expiratory volume in 1 s 1.0l, 40% predicted), we measured the 6-min walk distance and the visual analogue scale dyspnoea scores before the start of treatment, prior to discharge and after a 4-week stable period. Additionally, the conventional clinical parameters of COPD and quality of life were documented.
The 6-min walk distance was significantly increased from 97 ± 114 m to 290 ± 106 m. After 4 weeks of outpatient treatment in clinically stable patients, the 6-min walk distance fell non-significantly to 270 ± 120 m. The increment in walk distance fell significantly with advancing severity of COPD: from 112 ± 68 m for grade I and II to 56 ± 88 m for grade IV. Resting as well as exertional dyspnoea scores were significantly reduced (resting dyspnoea from 4 to 2 and exertional dyspnoea from 8 to 6).
We were able to demonstrate that 6-min walk test and dyspnoea scores, but not pulmonary function test, are suitable parameters to assess the course of COPD exacerbations.