The Relationship Between Recovery Rate From Exertional Desaturation, Disease Severity and Mortality in Patients With Fibrotic Interstitial Lung Disease
Notice bibliographique
Résumé
Abstract RATIONALE: In patients with fibrotic interstitial lung disease (fILD), both oxygen desaturation during exertion and a reduced distance in the six-minute walk test (6MWT) are recognized as independent predictors of mortality. Additionally, experiencing exertional desaturation and a shorter 6MWT distance correlates with increased disease severity, faster progression, and poorer clinical outcomes, including mortality. The recovery rate of peripheral oxygen saturation (SpO₂) after the 6MWT can vary among fILD patients and may change for individuals as their disease worsens or as they develop other co-morbidities. This study aims to explore the relationship between the recovery index (RI) of desaturation after 6MWT and both disease severity and survival in patients with fILD. METHODS: This prospective study enrolled patients with fILD undergoing clinical 6MWT at the University of Calgary ILD program in 2022, with follow-up through October 2024. The 6MWT was administered according to consensus guidelines with continuous pulse oximetry monitoring. Patients with exertional desaturation greater than 3% were included in the analysis. Post-test SpO₂ levels were recorded every 15 seconds for up to 180 seconds or until SpO₂ returned to baseline. RI was calculated using the formula: RI = ([SpO₂(baseline) – SpO₂(end6MWT) + O₂ Flow (LPM)] / [181 – recovery time(s)])[asterisk]100, where a higher RI indicates slower recovery. Baseline characteristics were compared using chi-squared and two-tailed t-tests, while linear regression tested associations between RI and baseline forced vital capacity (FVC) % predicted and diffusion capacity (DLCO) % predicted. Kaplan-Meier plots estimated the unadjusted probability of survival. Cox proportional hazards regression tested the association of RI with risk of death in models adjusted for disease progression. RESULTS: Of 92 patients, 54 had exertional desaturation >3% during the 6MWT. Mean age was 68±9.8 years, 29 (53%) were female, and the most common diagnosis was connective tissue disease-associated ILD in 21 (39%). In unadjusted models, RI was associated with decreased FVC% (β=-0.16, 95%CI -0.2877 to -0.02721; p=0.0184) and DLCO% (β=-0.35, 95%CI -0.4889 to -0.2193; p= 0.0001). Additionally, there was a trend suggesting an association between higher RI and increased dyspnea (BORG-D score, β=1.23, 95%CI -0.2070 to 2.253; p=0.1013). Findings were consistent across all ILD subtypes. CONCLUSION: Prolonged recovery from exertional desaturation following 6MWT is linked to reduced lung function, more symptoms, and a higher risk of mortality in patients with fILD across the various subtypes. The recovery time from exertional desaturation could be an important clinical indicator for evaluating disease severity and predicting outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».