Predictors of oxygen desaturation during submaximal exercise in 8,000 patients

K. O. Hadeli, E. M. Siegel, Duane L Sherrill, K. C. Beck, P. L. Enright

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Study objectives: To determine predictors of oxygen desaturation during submaximal exercise in patients with various lung diseases. Design and setting: This retrospective case series used pulmonary function laboratory results from all patients referred to a major tertiary-care center. Patients and measurements: All patients ≥ 35 years old who underwent spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), lung volumes, and pulse oximetry during 3-min submaximal step-test exercise during 1996 were included (4,545 men and 3,472 women). Logistic regression models, correcting for gender, age, and weight, determined the odds ratios (ORs) for oxygen desaturation of ≥ 4% during exercise for each category of lung function abnormality (compared to those with entirely normal lung function). Results: Approximately 74% of the patients had airways obstruction, while only 5.6% had restriction of lung volumes. One third of those with obstruction had a low DLCO, compared to 56% with restriction, while 2.7% had a low DLCO without obstruction or restriction. The risk of oxygen desaturation during submaximal exercise was very high (OR, 34) in patients with restriction and low DLCO (as in interstitial lung disease) and in patients with obstruction and low DLCO (as in COPD; OR, 18), intermediate (OR, 9) in patients with only a low DLCO, and lowest in those with a normal DLCO (OR, 4 if restricted; OR, 2 if obstructed). A cut point of DLCO < 62% predicted resulted in 75% sensitivity and specificity for exercise desaturation. No untoward cardiac events occurred in any patients during or following the submaximal exercise tests. Conclusions: The risk of oxygen desaturation during submaximal exercise is very high in patients with a low DLCO. Submaximal exercise tests are safe, even in elderly patients with heart and lung diseases.

Original languageEnglish (US)
Pages (from-to)88-92
Number of pages5
JournalChest
Volume120
Issue number1
DOIs
StatePublished - 2001

Fingerprint

Exercise
Oxygen
Odds Ratio
Lung
Exercise Test
Lung Diseases
Logistic Models
Lung Volume Measurements
Oximetry
Spirometry
Interstitial Lung Diseases
Airway Obstruction
Carbon Monoxide
Tertiary Care Centers
Chronic Obstructive Pulmonary Disease
Heart Diseases
Weights and Measures
Sensitivity and Specificity

Keywords

  • Asthma
  • Chronic bronchitis
  • Emphysema
  • Interstitial lung diseases
  • Oximetry
  • Oxygen desaturation
  • Pulmonary function tests
  • Submaximal exercise

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Predictors of oxygen desaturation during submaximal exercise in 8,000 patients. / Hadeli, K. O.; Siegel, E. M.; Sherrill, Duane L; Beck, K. C.; Enright, P. L.

In: Chest, Vol. 120, No. 1, 2001, p. 88-92.

Research output: Contribution to journalArticle

Hadeli, K. O. ; Siegel, E. M. ; Sherrill, Duane L ; Beck, K. C. ; Enright, P. L. / Predictors of oxygen desaturation during submaximal exercise in 8,000 patients. In: Chest. 2001 ; Vol. 120, No. 1. pp. 88-92.
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abstract = "Study objectives: To determine predictors of oxygen desaturation during submaximal exercise in patients with various lung diseases. Design and setting: This retrospective case series used pulmonary function laboratory results from all patients referred to a major tertiary-care center. Patients and measurements: All patients ≥ 35 years old who underwent spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), lung volumes, and pulse oximetry during 3-min submaximal step-test exercise during 1996 were included (4,545 men and 3,472 women). Logistic regression models, correcting for gender, age, and weight, determined the odds ratios (ORs) for oxygen desaturation of ≥ 4{\%} during exercise for each category of lung function abnormality (compared to those with entirely normal lung function). Results: Approximately 74{\%} of the patients had airways obstruction, while only 5.6{\%} had restriction of lung volumes. One third of those with obstruction had a low DLCO, compared to 56{\%} with restriction, while 2.7{\%} had a low DLCO without obstruction or restriction. The risk of oxygen desaturation during submaximal exercise was very high (OR, 34) in patients with restriction and low DLCO (as in interstitial lung disease) and in patients with obstruction and low DLCO (as in COPD; OR, 18), intermediate (OR, 9) in patients with only a low DLCO, and lowest in those with a normal DLCO (OR, 4 if restricted; OR, 2 if obstructed). A cut point of DLCO < 62{\%} predicted resulted in 75{\%} sensitivity and specificity for exercise desaturation. No untoward cardiac events occurred in any patients during or following the submaximal exercise tests. Conclusions: The risk of oxygen desaturation during submaximal exercise is very high in patients with a low DLCO. Submaximal exercise tests are safe, even in elderly patients with heart and lung diseases.",
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AB - Study objectives: To determine predictors of oxygen desaturation during submaximal exercise in patients with various lung diseases. Design and setting: This retrospective case series used pulmonary function laboratory results from all patients referred to a major tertiary-care center. Patients and measurements: All patients ≥ 35 years old who underwent spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), lung volumes, and pulse oximetry during 3-min submaximal step-test exercise during 1996 were included (4,545 men and 3,472 women). Logistic regression models, correcting for gender, age, and weight, determined the odds ratios (ORs) for oxygen desaturation of ≥ 4% during exercise for each category of lung function abnormality (compared to those with entirely normal lung function). Results: Approximately 74% of the patients had airways obstruction, while only 5.6% had restriction of lung volumes. One third of those with obstruction had a low DLCO, compared to 56% with restriction, while 2.7% had a low DLCO without obstruction or restriction. The risk of oxygen desaturation during submaximal exercise was very high (OR, 34) in patients with restriction and low DLCO (as in interstitial lung disease) and in patients with obstruction and low DLCO (as in COPD; OR, 18), intermediate (OR, 9) in patients with only a low DLCO, and lowest in those with a normal DLCO (OR, 4 if restricted; OR, 2 if obstructed). A cut point of DLCO < 62% predicted resulted in 75% sensitivity and specificity for exercise desaturation. No untoward cardiac events occurred in any patients during or following the submaximal exercise tests. Conclusions: The risk of oxygen desaturation during submaximal exercise is very high in patients with a low DLCO. Submaximal exercise tests are safe, even in elderly patients with heart and lung diseases.

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