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The 6-min walking distance: long-term follow up in patients with COPD

C. Casanova, C. G. Cote, J. M. Marin, J. P. de Torres, A. Aguirre-Jaime, R. Mendez, L. Dordelly, B. R. Celli
European Respiratory Journal 2007 29: 535-540; DOI: 10.1183/09031936.00071506
C. Casanova
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C. G. Cote
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J. M. Marin
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J. P. de Torres
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A. Aguirre-Jaime
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R. Mendez
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L. Dordelly
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B. R. Celli
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  • Fig. 1—
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    Fig. 1—

    Median 6-min walking distance (6MWD) over 5 yrs. Baseline median (range) 6MWD was 388 m (161–600 m; n = 294). It declined at 12.5m·yr-1 (95% confidence interval 8–17 m·yr-1) for up to 5 yrs (p = 0.001). –––––: median; -------: 95% confidence intervals. Year 4: n = 163; year 5: n = 100.

  • Fig. 2—
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    Fig. 2—

    Change in 6-min walking distance (6MWD) over time as a percentage of the predicted values (% pred) as reported by a) Enright and Sherrill 18 (2.1%·yr-1 (95% confidence interval (CI) 1.6–2.7%·yr-1); p<0.001); and b) Troosters et al. 19 (1.6%·yr-1 (95% CI 1.1–2.1%·yr-1); p<0.001). –––––: median; -------: 95% CI. Baseline, years 1–3: n = 294; year 4: n = 163; year 5: n = 100.

  • Fig. 3—
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    Fig. 3—

    The 6-min walking distance (6MWD) declines significantly in patients with a forced expiratory volume in one second (FEV1) <50% predicted (-------; 15.3 m·yr-1 (95% confidence interval (CI) 9.1–21.4 m·yr-1); p = 0.002). –––––: FEV1 >50% pred, years 0–3: n = 85; year 4: n = 44; year 5: n = 25). FEV1 <50% pred, years 0–3: n = 209; year 4: n = 119; year 5: n = 75).

  • Fig. 4—
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    Fig. 4—

    The decline in 6-min walk distance (○) was greater in patients with more severe airflow obstruction, as determined by Global initiative for Chronic Obstructive Lung Disease and American Thoracic Society/European Respiratory Society staging criteria. In contrast forced expiratory volume in one second (FEV1; •) changed less in those patients with more severe airflow limitation. Δ: change. Stage II: n = 81; stage III: n = 136; stage IV: n = 73.

Tables

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  • Table 1—

    Baseline characteristics of the patients

    Subjects n294
    Sex M/F285/9
    Age yrs66 (51–79)
    Current smokers %18
    BMI kg·m-227 (19–36)
    6MWD m388 (160–600)
    FEV1 L1.13 (0.64–2.22)
    FEV1 % pred39 (20–70)
    GOLD and ATS/ERS staging
     Stage I4 (1)
     Stage II81 (28)
     Stage III136 (46)
     Stage IV73 (25)
    IC/TLC0.28 (0.16–0.42)
    Charlson index4 (1–7)
    • Data are presented as n, median (5th–95th percentile) or n (%), unless otherwise stated. M: male; F: female; BMI: body mass index; 6MWD: 6-min walking distance; FEV1: forced expiratory volume in one second; % pred: % predicted; GOLD: Global Initiative for Chronic Obstructive Lung Disease; ATS: American Thoracic Society; ERS: European Respiratory Society; IC: inspiratory capacity; TLC: total lung capacity.

  • Table 2—

    Characteristics of the cohort according to country

    USASpainp-value
    Subjects20084
    Sex M/F193/783/10.443
    Age yrs66 (51–79)67 (47–76)0.461
    BMI kg·m-227 (18–37)27 (19–36)0.658
    6MWD m350 (146–503)463 (336–635)<0.001
    FEV1 L1.20 (0.6–2.1)1.15 (0.6–2.3)0.946
    FEV1 % pred37 (19–67)43 (21–75)0.014
    IC/TLC0.29 (0.14–0.42)0.28 (0.13–0.44)0.385
    Charlson index4 (2–8)2 (1–6)<0.001
    • Data are presented as n or median (5th–95th percentile). M: male; F: female; BMI: body mass index; 6MWD: 6-min walking distance; FEV1: forced expiratory volume in one second; % pred: % predicted; IC: inspiratory capacity; TLC: total lung capacity.

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The 6-min walking distance: long-term follow up in patients with COPD
C. Casanova, C. G. Cote, J. M. Marin, J. P. de Torres, A. Aguirre-Jaime, R. Mendez, L. Dordelly, B. R. Celli
European Respiratory Journal Mar 2007, 29 (3) 535-540; DOI: 10.1183/09031936.00071506

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The 6-min walking distance: long-term follow up in patients with COPD
C. Casanova, C. G. Cote, J. M. Marin, J. P. de Torres, A. Aguirre-Jaime, R. Mendez, L. Dordelly, B. R. Celli
European Respiratory Journal Mar 2007, 29 (3) 535-540; DOI: 10.1183/09031936.00071506
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