The 6-minute walk test predicts mortality in a pulmonary nontuberculous mycobacteria-predominant bronchiectasis cohort

Journal Article · Fri Jan 21 00:00:00 EST 2022 · BMC Infectious Diseases

DOI:https://doi.org/10.1186/s12879-022-07054-6· OSTI ID:1983039

Blakney, Rebekah A. ^[1]; Ricotta, Emily E. ^[1]; Follmann, Dean ^[1]; Drew, Jessica ^[1]; Carey, Kelly A. ^[1]; Glass, Lisa N. ^[2]; Robinson, Chevalia ^[3]; MacDonald, Sandra ^[3]; McShane, Pamela J. ^[4]; Olivier, Kenneth N. ^[3]; Fennelly, Kevin ^[3]; Prevots, D. Rebecca ^[1]

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1. National Institutes of Health (NIH), Bethesda, MD (United States). National Institute of Allergy and Infectious Diseases (NIAID)
2. George Washington Univ., Washington, DC (United States). School of Medicine and Health Sciences; National Institutes of Health (NIH), Bethesda, MD (United States). National Heart, Lung, and Blood Institute
3. National Institutes of Health (NIH), Bethesda, MD (United States). National Heart, Lung, and Blood Institute
4. Univ. of Texas, Tyler, TX (United States). Health Science Center

Background: Bronchiectasis is a chronic lung condition frequently associated with nontuberculous mycobacteria pulmonary (NTM) disease. Persons with these conditions are at increased risk of mortality. Patient reported outcome (PRO) instruments and the 6-minute walk test (6MWT) have been shown to predict mortality for several lung conditions, but these measures have not been fully evaluated for bronchiectasis and NTM. Methods: We conducted a retrospective cohort study among adult patients enrolled in a natural history study of bronchiectasis at the National Heart, Lung, and Blood Institute. Electronic medical records were queried for demographic, clinical, microbiologic, radiographic, and PRO instrument data: St. George’s Respiratory Questionnaire (SGRQ), Medical Research Council Dyspnea Scale, and the Pulmonary Symptom Severity Score (PSSS). The study baseline date was defined as the patient’s first visit after January 1st, 2015 with a SGRQ or 6MWT completed. Follow-up was defined as the interval between the study baseline visit and date of death or December 31st, 2019. Sex-stratified Cox proportional-hazards regression was conducted to identify predictors of mortality. Separate models were run for each PRO and 6MWT measure, controlling for age, body mass index (BMI), fibrocavitary disease status, and M. abscessus infection. Results: In multivariable Cox proportional-hazards regression models, the PSSS-severity (aHR 1.29, 95% CI 1.04–1.59), the 6MWT total distance walked (aHR 0.938, 95% CI 0.896–0.981) and distance saturation product (aHR 0.930, 95% CI 0.887–0.974) independently predicted mortality. In addition, BMI was significantly predictive of mortality in all models. Conclusions: The 6MWT and a PRO instrument capturing symptom severity are independently predictive of mortality in our cohort of bronchiectasis patients.

• Research Organization: Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN (United States)
• Sponsoring Organization: USDOE Office of Science (SC)
• Grant/Contract Number: SC0014664
• OSTI ID: 1983039
• Journal Information: BMC Infectious Diseases, Journal Name: BMC Infectious Diseases Journal Issue: 1 Vol. 22; ISSN 1471-2334
• Publisher: BMC - Springer Nature
• Country of Publication: United States
• Language: English

Related Subjects

6-minute walk test
60 APPLIED LIFE SCIENCES
Bronchiectasis
Health-related quality of life
Infectious diseases
Mortality
Nontuberculous mycobacteria
Patient reported outcomes