 |
|
Shorter distance on six-minute walk test points up a greater risk of death
September 18, 2006For idiopathic pulmonary fibrosis (IPF) patients awaiting lung transplantation, a simple walk test can predict mortality rates. A new study found that individuals with IPF who can cover less than 680 feet during the six-minute test are four times more likely to die than those who can walk greater distances.
The research appears in the second issue for September 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
David J. Lederer, M.D., of the Division of Pulmonary, Allergy and Critical Care Medicine at Columbia University College of Physicians and Surgeons in New York City, and five associates examined the records of 454 adult IPF patients on U.S. transplantation waiting lists.
In IPF, lung tissue is damaged by an unknown cause. The walls of the air sacs become inflamed, which leads to scarring or fibrosis. As a result, patients with IPF frequently suffer from progressive respiratory failure. Eventually, the scarring causes permanent loss of the lungs' ability to transport oxygen.
To date, lung transplantation is the only medical therapy that has been shown to improve survival. Twenty-percent of all lung transplant procedures performed worldwide involve patients with IPF.
The investigators call the six-minute walk test a "simple, safe, reliable and inexpensive" way to assess the self-paced exercise capacity of IPF patients. It varies little when repeated on the same person over a short period of time.
"A total of 209 patients had a six-month follow-up without undergoing lung transplantation," said Dr. Lederer. "Forty-nine of these patients, 23 percent, died during that time period. The six-minute walk test's ability to separate those alive at six months from those who died was not only significantly better than chance, but also superior to the forced vital capacity percent (FVC%) predicted test."
The authors noted that a lower six-minute walking distance was associated with more severe lung disease, status as a minority and lower educational attainment in a nationwide cohort of patients with IPF who were listed for lung transplantation.
The test also predicted waitlist mortality independently of age, sex, race, lung function indices, presence of pulmonary hypertension and other potential confounders.
According to the investigators, the six-minute walk test has at least four advantages over other tests: 1) it is less costly than other tools; 2) it can be performed on patients with severe hypoxemia (inadequate amounts of oxygen in the blood) who require continuous high-flow oxygen; 3) it can be performed in any sufficiently long hallway by appropriately trained personnel; and 4) it does not require specialized equipment and expertise found only in established pulmonary function laboratories;
The authors concluded that a test like FVC% predicted might not be valid for gauging survival in patients with IPF who have been listed for lung transplantation because of the serious nature of their illness.
American Thoracic Society
In IPF, lung tissue is damaged by an unknown cause. The walls of the air sacs become inflamed, which leads to scarring or fibrosis. As a result, patients with IPF frequently suffer from progressive respiratory failure. Eventually, the scarring causes permanent loss of the lungs' ability to transport oxygen.
To date, lung transplantation is the only medical therapy that has been shown to improve survival. Twenty-percent of all lung transplant procedures performed worldwide involve patients with IPF.
The investigators call the six-minute walk test a "simple, safe, reliable and inexpensive" way to assess the self-paced exercise capacity of IPF patients. It varies little when repeated on the same person over a short period of time.
"A total of 209 patients had a six-month follow-up without undergoing lung transplantation," said Dr. Lederer. "Forty-nine of these patients, 23 percent, died during that time period. The six-minute walk test's ability to separate those alive at six months from those who died was not only significantly better than chance, but also superior to the forced vital capacity percent (FVC%) predicted test."
The authors noted that a lower six-minute walking distance was associated with more severe lung disease, status as a minority and lower educational attainment in a nationwide cohort of patients with IPF who were listed for lung transplantation.
The test also predicted waitlist mortality independently of age, sex, race, lung function indices, presence of pulmonary hypertension and other potential confounders.
According to the investigators, the six-minute walk test has at least four advantages over other tests: 1) it is less costly than other tools; 2) it can be performed on patients with severe hypoxemia (inadequate amounts of oxygen in the blood) who require continuous high-flow oxygen; 3) it can be performed in any sufficiently long hallway by appropriately trained personnel; and 4) it does not require specialized equipment and expertise found only in established pulmonary function laboratories;
The authors concluded that a test like FVC% predicted might not be valid for gauging survival in patients with IPF who have been listed for lung transplantation because of the serious nature of their illness.
American Thoracic Society
Idiopathic Pulmonary Fibrosis Current Events and Idiopathic Pulmonary Fibrosis News RSSNote to people with scarred and stiffened lungs: Monitor your sleep before severe fatigue sets in
Family, friends and neighbors remember Lisa Sandler Spaeth as an active mother of two in Potomac, Md., with a lot on the go, juggling her son's baseball games and her daughter's horseback-riding lessons with numerous committee obligations, organizing women's activities at her local synagogue.
Biomarkers identified for idiopathic pulmonary fibrosis
The first evidence of a distinctive protein signature that could help to transform the diagnosis and improve the monitoring of the devastating lung disease idiopathic pulmonary fibrosis (IPF) is being reported by University of Pittsburgh School of Medicine researchers in this month's edition of PLoS Medicine, an open-access journal of the Public Library of Science.
Rare Lung Disease Cells Indicate Higher Death Risk
Large numbers of certain cells in the lungs of patients diagnosed with idiopathic pulmonary fibrosis may increase their chance of death, UC researchers have discovered.
Smoking belies milder disease but worse prognosis for IPF patients
Smokers and ex-smokers with idiopathic pulmonary fibrosis (IPF), an untreatable progressive lung disease that usually leads to death within a few years of diagnosis, have a worse prognosis than non-smokers, according to research from London.
Translational research patented first experimental treatment against idiopathic pulmonary fibrosis
Idiopathic pulmonary fibrosis is a disease with unknown cause with a very severe prognosis; when detected, it is already in an advanced stage.
Molecular pathway appears crucial in development of pulmonary fibrosis
A study led by Massachusetts General Hospital (MGH) researchers may have found a key mechanism underlying idiopathic pulmonary fibrosis (IPF), a usually fatal lung disease for which transplantation is the only successful treatment.
Gene expression patterns predict rapid decline in idiopathic pulmonary fibrosis patients
Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease typically characterized by the slow but progressive onset of shortness of breath or cough.
Extra-aggressive form of idiopathic pulmonary fibrosis identified
Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive lung disorder from which most patients die within 5 years after diagnosis. The disease is characterized by the insidious onset of dyspnea or cough and usually evolves slowly.
Gene mutations linked to hereditary lung disease
Scientists at Johns Hopkins have identified the genetic culprits that trigger a hereditary form of a fatal lung disease. The findings, published in the March 29, 2007 issue of the New England Journal of Medicine, may provide new directions in diagnosis and treatment for families that inherit genes for the disease, as well as for those that develop non-inherited forms of the illness.
Proteins may predict lung transplant rejection
Using the latest in high tech tools, researchers have identified three proteins that were highly predictive of chronic lung rejection up to 20 months before the rejection occurred.
More Idiopathic Pulmonary Fibrosis Current Events and Idiopathic Pulmonary Fibrosis News Articles
 | The Official Patient's Sourcebook on Idiopathic Pulmonary Fibrosis by James N. Parker This book has been created for patients who have decided to make education and research an integral part of the treatment process. Although it also gives information useful to doctors, caregivers and other health professionals, it tells patients where and how to look for information covering virtually all topics related to idiopathic pulmonary fibrosis (also alveolocapillary block; cryptogenic... |
 | Idiopathic Pulmonary Fibrosis Medical Guide by Qontro Medical Guides The Idiopathic Pulmonary Fibrosis Medical Guide is a publication which has been designed to better help readers understand Idiopathic Pulmonary Fibrosis. This Qontro Medical Guide has been designed with the reader in mind, and is a useful information source for readers at all levels looking to learn more about Idiopathic Pulmonary Fibrosis. The Idiopathic Pulmonary Fibrosis Medical Guide is... |
 | Idiopathic Pulmonary Fibrosis (Lung Biology in Health and Disease) A discussion of the epidemiology, clinical features, and differential diagnoses of idiopathic pulmonary fibrosis (IPF). Key topics include the role of polymorphonuclear leukocytes in the pathogenesis of pulmonary fibrosis, and current treatment options, including medical therapy and lung... |
| Idiopathic pulmonary fibrosis (Medical Grand Rounds) by Galen B Toews | |
| The Official Patient's Sourcebook on Idiopathic Pulmonary Fibrosis by Icon Health Publications | |
| Pulmonary Arterial Hypertension and Interstitial Lung Diseases: A Clinical Guide Interstitial lung disease (ILD) is a broad category of lung diseases that includes more than 150 disorders characterized by scarring or fibrosis of the lungs. In Pulmonary Arterial Hypertension and Interstitial Lung Disease: A Clinical Guide, renowned experts provide a state-of-the-art overview of the problems seen by physicians in the clinical management of ILDs. Divided into two sections, the... |
| © 2008 BrightSurf.com |