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The 6-min walk distance: change over time and value as a predictor of survival in severe COPD

¹ Division of Pulmonary and Critical Care Medicine, St Elizabeth's Medical Center, Tufts University School of Medicine, ² Department of Biostatistics Boston University Schoolof Public Health, Boston, and ³ Pulmonary-Critical Care Medicine Bay Pines VA Medical Center, Tampa, FL, USA

CORRESPONDENCE: B.R. Celli, St Elizabeth's Medical Center, 736 Cambridge Street, Boston, MA 02135, USA. Fax: 1 6175627756. E-mail: bcelli@cchcs.org

Keywords: chronic obstructive pulmonary disease, functional capacity, 6-min walk distance

Received: March 27, 2003
Accepted September 23, 2003

The 6-min walk distance (6MWD) is used to evaluate the functional capacity of patients with chronic obstructive pulmonary disease (COPD). The change in 6MWD over time and its correlation with changes in spirometry and survival are unclear.

Patients (n=198) with severe COPD and 41 age-matched controls were followed for 2 yrs, and anthropometrics, spirometry, 6MWD and comorbidities were measured.

The 6MWD decreased in the COPD group from 238±107 m to 218±112 m (–26±37 m·yr^–1), and increased in the control group from 532±82 m to 549±86 m (12±25 m·yr^–1). In both groups, there was a poor correlation with changes in forced expiratory volume in one second (FEV₁). Nonsurvivors in the COPD group (42%) had a more pronounced change in the 6MWD (–40 versus –22 m·yr^–1) but a similar change in FEV₁ (118 versus 102 mL·yr^–1). The 6MWD independently predicted survival, after accounting for age, body mass index, FEV₁ and comorbidities.

In severe chronic obstructive pulmonary disease, the 6-min walk distance predicts mortality better than other traditional markers of disease severity. Its measurement is useful in the comprehensive evaluation of patients with severe disease.

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