Fluctuation of peripheral saturation oxygen and the risk factors for pre-discharge chronic obstructive pulmonary disease patients with early desaturation experienced
10.3969/j.issn.1000-6710.2024.10.003
- VernacularTitle:预出院慢性阻塞性肺疾病患者发生早期运动性低氧的血氧波动特点及危险因素分析
- Author:
Qian QIAN
1
;
Hao CHEN
;
Jingwen JIAO
;
Lin DONG
Author Information
1. 蚌埠医科大学附属合肥市第二人民医院呼吸与危重症医学科,合肥 230011;合肥市第二人民医院呼吸与危重症医学科,合肥 230011
- Publication Type:Journal Article
- Keywords:
pulmonary disease,chronic obstructive;
exercise induced desaturation;
6-minute walk test;
early desaturation
- From:
Chinese Journal of Sports Medicine
2024;43(10):783-790
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the saturation of peripheral oxygen(SpO2) fluctuation for early exer-cise induced desaturation in chronic obstructive pulmonary disease(COPD) patients ready for discharge and capable of basic self-care and analyze its risk factors.Methods A total of 142 COPD patients ready for discharge and capable of basic self-care,hospitalized in the Department of Pulmonary and Critical Care Medicine at the Second People's Hospital of Hefei,affiliated to Bengbu Medical Universi-ty,between May 2021 and May 2024,were selected.Based on whether exercise induced desaturation occurred during the 6-minute walk test(6MWT) and the timing of its onset,all patients were random-ly divided into a non-exercise induced desaturation(NEID) group,an early desaturation(ED) group,and a non-early desaturation(NED) group.The general data,lung function,and SpO2 fluctuation were compared among the three groups.Generalized estimating equation was used to analyze the SpO2 fluctu-ation for the occurrence of ED,and multivariable logistic regression was applied to analyze the risk factors for ED.Moreover,the receiver operating characteristic(ROC) curve was employed to evaluate the predictive value of these factors.Results Compared with the NEID group,the ED group had a low-er forced expiratory volume in the first second to the predicted value ratio(FEV1％pred),and the NED group had a higher proportion of patients complicated with emphysema(both P<0.05).During exercise,the ED group exhibited significantly lower mean SpO2(SpO2mean),minimum SpO2(SpO2min),the gap be-tween resting saturation of peripheral oxygen(SpO2rest)and SpO2min (?SpO2) compared to the other two groups(P<0.001 for all).The generalized estimating equation showed that there were significant differ-ences in the inter-group effect,time effect,and interaction effect of SpO2 among the three groups(P<0.001 for all).Moreover,SpO2 values of ED group were significantly lower than the other two groups at all exercise time points(P<0.001 for all).Univariate and multivariate logistic regression analyses showed that ?SpO2[OR=1.169;95％CI(1.011～1.352);P<0.05]was a risk factor for ED,while SpO2mean[OR=0.776;95％CI(0.637～0.947);P<0.05]was a protective factor.Meanwhile,the ROC curve for ?SpO2 predicting ED had an area under the curve (AUC) of 0.829,with a sensitivity of 0.714 and a speci-ficity of 0.785.Conclusion COPD patients ready for discharge and capable of basic self-care show more pronounced desaturation during exercise and greater SpO2 fluctuations when early desaturation oc-curs.?SpO2 is a risk factor for ED and has predictive value,which can be used for clinical diagno-sis and treatment.
