Desaturation during the 3-Minute step test predicts impaired 12-month outcomes in adult patients with cystic fibrosis

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Abstract

BACKGROUND: The 3-minute step test is a simple test of exercise capacity for children with cystic fibrosis (CF), but no data have been reported regarding its usefulness in adults or its prognostic value. OBJECTIVE: To determine the feasibility and acceptability of the 3-minute step test as a test of exercise capacity in adults with CF and whether test performance is associated with 12-month clinical outcomes. METHODS: From our out-patient clinic we prospectively recruited consecutive adult patients with CF in stable health. The 3-minute step test was conducted with a standardized protocol that included a 15-cm high step and external pacing at 30 steps/min. We measured heart rate, dyspnea, and SpO2. With multiple linear regression analyses we assessed the relationships between step-test performance and change in FEV1 and hospital days at 12 months. RESULTS: The participants were 101 adults: 56 male, mean ± SD age 29 ± 9 years, percent-of-predicted FEV1 61 ± 23%, body mass index 22 ± 4 kg/m2. Only 42% of the participants with mild CF achieved 70% of the predicted maximum heart rate during the 3-minute step test, compared to 77% of those with FEV1 < 60% of predicted. The 22 patients who desaturated to < 90% during the 3-minute step test had a larger number of hospital days over the following 12 months than did those who did not (median 28 d vs 11 d, P <.001). Those who desaturated also had a greater FEV1 decline (mean difference -117 mL, 95% CI -215 to -19 mL). Desaturation during the 3-minute step test was an independent predictor of both FEV1 decline and days spent in hospital. CONCLUSIONS: Desaturation during the 3-minute step test is associated with long-term pulmonary deterioration and more hospital days in adults with CF. The 3-minute step test may be a useful screening test for patients with moderate to severe CF lung disease, who require increased intervention and monitoring.

Original languageEnglish
Pages (from-to)1137-1142
Number of pages6
JournalRespiratory care
Volume56
Issue number8
DOIs
Publication statusPublished - Aug 2011

Keywords

  • Cystic fibrosis
  • Exercise test
  • Prognosis
  • Respiratory function tests

Cite this

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title = "Desaturation during the 3-Minute step test predicts impaired 12-month outcomes in adult patients with cystic fibrosis",
abstract = "BACKGROUND: The 3-minute step test is a simple test of exercise capacity for children with cystic fibrosis (CF), but no data have been reported regarding its usefulness in adults or its prognostic value. OBJECTIVE: To determine the feasibility and acceptability of the 3-minute step test as a test of exercise capacity in adults with CF and whether test performance is associated with 12-month clinical outcomes. METHODS: From our out-patient clinic we prospectively recruited consecutive adult patients with CF in stable health. The 3-minute step test was conducted with a standardized protocol that included a 15-cm high step and external pacing at 30 steps/min. We measured heart rate, dyspnea, and SpO2. With multiple linear regression analyses we assessed the relationships between step-test performance and change in FEV1 and hospital days at 12 months. RESULTS: The participants were 101 adults: 56 male, mean ± SD age 29 ± 9 years, percent-of-predicted FEV1 61 ± 23{\%}, body mass index 22 ± 4 kg/m2. Only 42{\%} of the participants with mild CF achieved 70{\%} of the predicted maximum heart rate during the 3-minute step test, compared to 77{\%} of those with FEV1 < 60{\%} of predicted. The 22 patients who desaturated to < 90{\%} during the 3-minute step test had a larger number of hospital days over the following 12 months than did those who did not (median 28 d vs 11 d, P <.001). Those who desaturated also had a greater FEV1 decline (mean difference -117 mL, 95{\%} CI -215 to -19 mL). Desaturation during the 3-minute step test was an independent predictor of both FEV1 decline and days spent in hospital. CONCLUSIONS: Desaturation during the 3-minute step test is associated with long-term pulmonary deterioration and more hospital days in adults with CF. The 3-minute step test may be a useful screening test for patients with moderate to severe CF lung disease, who require increased intervention and monitoring.",
keywords = "Cystic fibrosis, Exercise test, Prognosis, Respiratory function tests",
author = "Holland, {Anne E.} and Tshepo Rasekaba and Wilson, {John W.} and Button, {Brenda M.}",
year = "2011",
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Desaturation during the 3-Minute step test predicts impaired 12-month outcomes in adult patients with cystic fibrosis. / Holland, Anne E.; Rasekaba, Tshepo; Wilson, John W.; Button, Brenda M.

In: Respiratory care, Vol. 56, No. 8, 08.2011, p. 1137-1142.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Desaturation during the 3-Minute step test predicts impaired 12-month outcomes in adult patients with cystic fibrosis

AU - Holland, Anne E.

AU - Rasekaba, Tshepo

AU - Wilson, John W.

AU - Button, Brenda M.

PY - 2011/8

Y1 - 2011/8

N2 - BACKGROUND: The 3-minute step test is a simple test of exercise capacity for children with cystic fibrosis (CF), but no data have been reported regarding its usefulness in adults or its prognostic value. OBJECTIVE: To determine the feasibility and acceptability of the 3-minute step test as a test of exercise capacity in adults with CF and whether test performance is associated with 12-month clinical outcomes. METHODS: From our out-patient clinic we prospectively recruited consecutive adult patients with CF in stable health. The 3-minute step test was conducted with a standardized protocol that included a 15-cm high step and external pacing at 30 steps/min. We measured heart rate, dyspnea, and SpO2. With multiple linear regression analyses we assessed the relationships between step-test performance and change in FEV1 and hospital days at 12 months. RESULTS: The participants were 101 adults: 56 male, mean ± SD age 29 ± 9 years, percent-of-predicted FEV1 61 ± 23%, body mass index 22 ± 4 kg/m2. Only 42% of the participants with mild CF achieved 70% of the predicted maximum heart rate during the 3-minute step test, compared to 77% of those with FEV1 < 60% of predicted. The 22 patients who desaturated to < 90% during the 3-minute step test had a larger number of hospital days over the following 12 months than did those who did not (median 28 d vs 11 d, P <.001). Those who desaturated also had a greater FEV1 decline (mean difference -117 mL, 95% CI -215 to -19 mL). Desaturation during the 3-minute step test was an independent predictor of both FEV1 decline and days spent in hospital. CONCLUSIONS: Desaturation during the 3-minute step test is associated with long-term pulmonary deterioration and more hospital days in adults with CF. The 3-minute step test may be a useful screening test for patients with moderate to severe CF lung disease, who require increased intervention and monitoring.

AB - BACKGROUND: The 3-minute step test is a simple test of exercise capacity for children with cystic fibrosis (CF), but no data have been reported regarding its usefulness in adults or its prognostic value. OBJECTIVE: To determine the feasibility and acceptability of the 3-minute step test as a test of exercise capacity in adults with CF and whether test performance is associated with 12-month clinical outcomes. METHODS: From our out-patient clinic we prospectively recruited consecutive adult patients with CF in stable health. The 3-minute step test was conducted with a standardized protocol that included a 15-cm high step and external pacing at 30 steps/min. We measured heart rate, dyspnea, and SpO2. With multiple linear regression analyses we assessed the relationships between step-test performance and change in FEV1 and hospital days at 12 months. RESULTS: The participants were 101 adults: 56 male, mean ± SD age 29 ± 9 years, percent-of-predicted FEV1 61 ± 23%, body mass index 22 ± 4 kg/m2. Only 42% of the participants with mild CF achieved 70% of the predicted maximum heart rate during the 3-minute step test, compared to 77% of those with FEV1 < 60% of predicted. The 22 patients who desaturated to < 90% during the 3-minute step test had a larger number of hospital days over the following 12 months than did those who did not (median 28 d vs 11 d, P <.001). Those who desaturated also had a greater FEV1 decline (mean difference -117 mL, 95% CI -215 to -19 mL). Desaturation during the 3-minute step test was an independent predictor of both FEV1 decline and days spent in hospital. CONCLUSIONS: Desaturation during the 3-minute step test is associated with long-term pulmonary deterioration and more hospital days in adults with CF. The 3-minute step test may be a useful screening test for patients with moderate to severe CF lung disease, who require increased intervention and monitoring.

KW - Cystic fibrosis

KW - Exercise test

KW - Prognosis

KW - Respiratory function tests

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