Distance travelled in the six-minute walk test in patients with chronic obstructive pulmonary disease as a predictor of mortality

Abstract Background Exercise intolerance in patients with COPD has significant implications for quality of life, hospitalization rates, and survival. Objective To assess functional capacity using the six-minute walk test (6MWT) by categorizing the distance walked in six minutes (6MWD) into tertiles...

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Main Authors: Izadora Moraes Dourado, Cássia da Luz Goulart, Aldair Darlan Santos-de-Araújo, Renan Shida Marinho, Adriana Sanches Garcia-Araujo, Meliza Goi Roscani, Renata Trimer, Andrea Lucia Gonçalves da Silva, Renata Gonçalves Mendes, Audrey Borghi-Silva
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-025-03721-x
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author Izadora Moraes Dourado
Cássia da Luz Goulart
Aldair Darlan Santos-de-Araújo
Renan Shida Marinho
Adriana Sanches Garcia-Araujo
Meliza Goi Roscani
Renata Trimer
Andrea Lucia Gonçalves da Silva
Renata Gonçalves Mendes
Audrey Borghi-Silva
author_facet Izadora Moraes Dourado
Cássia da Luz Goulart
Aldair Darlan Santos-de-Araújo
Renan Shida Marinho
Adriana Sanches Garcia-Araujo
Meliza Goi Roscani
Renata Trimer
Andrea Lucia Gonçalves da Silva
Renata Gonçalves Mendes
Audrey Borghi-Silva
author_sort Izadora Moraes Dourado
collection DOAJ
description Abstract Background Exercise intolerance in patients with COPD has significant implications for quality of life, hospitalization rates, and survival. Objective To assess functional capacity using the six-minute walk test (6MWT) by categorizing the distance walked in six minutes (6MWD) into tertiles and to assess the impact of this functional capacity on predictors of survival over a 24-month follow-up in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods This prospective cohort study followed 118 patients with COPD for 24 months. Participants were stratified based on the 6MWD: Group 1 (mean distance 590–424 m); Group 2 (mean distance 423–337 m); and Group 3 (mean distance < 336 m). Symptoms and disease severity were assessed using CAT scores. Kaplan-Meier was used to determine the association between 6MWD and all-cause mortality. Results The 6MWD, stratified by functional performance, was a significant predictor of survival in patients with COPD, despite heterogeneity in disease severity between groups. The 6MWD, stratified by functional performance, was a significant predictor of survival in patients with COPD, despite heterogeneity in disease severity between groups. Furthermore, in regression analysis for mortality, it was identified for 6MWD (CI 0.994; p = 0.043) and peripheral oxygen saturation (SpO₂) (CI 0.735; p < 0.001). Kaplan-Meier survival analysis revealed that patients who walked less than 336 m in the 6MWD had the lowest probability of survival at 24 months (log-rank p < 0.05). Conclusion The 6MWD is a robust predictor of mortality over a 2-year period in patients with COPD, reflecting a broad spectrum of disease severity. Poorer 6MWD performance is associated with increased desaturation, impaired heart rate recovery, and greater symptom burden during exercise, as indicated by CAT scores. Clinical trial number Not applicable.
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spelling doaj-art-8670f8a4d6064993be881983e8b641a52025-08-20T02:29:50ZengBMCBMC Pulmonary Medicine1471-24662025-05-0125111010.1186/s12890-025-03721-xDistance travelled in the six-minute walk test in patients with chronic obstructive pulmonary disease as a predictor of mortalityIzadora Moraes Dourado0Cássia da Luz Goulart1Aldair Darlan Santos-de-Araújo2Renan Shida Marinho3Adriana Sanches Garcia-Araujo4Meliza Goi Roscani5Renata Trimer6Andrea Lucia Gonçalves da Silva7Renata Gonçalves Mendes8Audrey Borghi-Silva9Cardiopulmonary Physical Therapy Laboratory, Federal University of São Carlos - UFSCar, São CarlosCardiopulmonary Physical Therapy Laboratory, Federal University of São Carlos - UFSCar, São CarlosCardiopulmonary Physical Therapy Laboratory, Federal University of São Carlos - UFSCar, São CarlosCardiopulmonary Physical Therapy Laboratory, Federal University of São Carlos - UFSCar, São CarlosCardiopulmonary Physical Therapy Laboratory, Federal University of São Carlos - UFSCar, São CarlosDepartment of Medicine, Federal University of Sao CarlosCardiopulmonary Physical Therapy Laboratory, Federal University of São Carlos - UFSCar, São CarlosDepartment of Sciences of Health, University of Santa Cruz do SulCardiopulmonary Physical Therapy Laboratory, Federal University of São Carlos - UFSCar, São CarlosCardiopulmonary Physical Therapy Laboratory, Federal University of São Carlos - UFSCar, São CarlosAbstract Background Exercise intolerance in patients with COPD has significant implications for quality of life, hospitalization rates, and survival. Objective To assess functional capacity using the six-minute walk test (6MWT) by categorizing the distance walked in six minutes (6MWD) into tertiles and to assess the impact of this functional capacity on predictors of survival over a 24-month follow-up in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods This prospective cohort study followed 118 patients with COPD for 24 months. Participants were stratified based on the 6MWD: Group 1 (mean distance 590–424 m); Group 2 (mean distance 423–337 m); and Group 3 (mean distance < 336 m). Symptoms and disease severity were assessed using CAT scores. Kaplan-Meier was used to determine the association between 6MWD and all-cause mortality. Results The 6MWD, stratified by functional performance, was a significant predictor of survival in patients with COPD, despite heterogeneity in disease severity between groups. The 6MWD, stratified by functional performance, was a significant predictor of survival in patients with COPD, despite heterogeneity in disease severity between groups. Furthermore, in regression analysis for mortality, it was identified for 6MWD (CI 0.994; p = 0.043) and peripheral oxygen saturation (SpO₂) (CI 0.735; p < 0.001). Kaplan-Meier survival analysis revealed that patients who walked less than 336 m in the 6MWD had the lowest probability of survival at 24 months (log-rank p < 0.05). Conclusion The 6MWD is a robust predictor of mortality over a 2-year period in patients with COPD, reflecting a broad spectrum of disease severity. Poorer 6MWD performance is associated with increased desaturation, impaired heart rate recovery, and greater symptom burden during exercise, as indicated by CAT scores. Clinical trial number Not applicable.https://doi.org/10.1186/s12890-025-03721-xChronic obstructive pulmonary diseaseSix-minute walk testCOPD assessment test
spellingShingle Izadora Moraes Dourado
Cássia da Luz Goulart
Aldair Darlan Santos-de-Araújo
Renan Shida Marinho
Adriana Sanches Garcia-Araujo
Meliza Goi Roscani
Renata Trimer
Andrea Lucia Gonçalves da Silva
Renata Gonçalves Mendes
Audrey Borghi-Silva
Distance travelled in the six-minute walk test in patients with chronic obstructive pulmonary disease as a predictor of mortality
BMC Pulmonary Medicine
Chronic obstructive pulmonary disease
Six-minute walk test
COPD assessment test
title Distance travelled in the six-minute walk test in patients with chronic obstructive pulmonary disease as a predictor of mortality
title_full Distance travelled in the six-minute walk test in patients with chronic obstructive pulmonary disease as a predictor of mortality
title_fullStr Distance travelled in the six-minute walk test in patients with chronic obstructive pulmonary disease as a predictor of mortality
title_full_unstemmed Distance travelled in the six-minute walk test in patients with chronic obstructive pulmonary disease as a predictor of mortality
title_short Distance travelled in the six-minute walk test in patients with chronic obstructive pulmonary disease as a predictor of mortality
title_sort distance travelled in the six minute walk test in patients with chronic obstructive pulmonary disease as a predictor of mortality
topic Chronic obstructive pulmonary disease
Six-minute walk test
COPD assessment test
url https://doi.org/10.1186/s12890-025-03721-x
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