title: Six-minute walk distance and dyspnoea scores to assess the course of COPD exacerbation in elderly patients.
abstract: BACKGROUND
  While the severity of stable chronic obstructive pulmonary disease (COPD) has been defined in a valid and relevant prognostic manner, parameters that describe the course of COPD exacerbations are not yet established. Physical performance and dyspnoea are of prognostic relevance in stable COPD. The issue investigated was to assess the course of COPD exacerbations to find parameters that describe this situation better.
  
  
  METHODS
  In 82 hospitalised patients with acute exacerbation of COPD who responded to intensified medical treatment (age 67.3 ± 9.5 years; forced expiratory volume in 1 s 1.0l, 40% predicted), we measured the 6-min walk distance and the visual analogue scale dyspnoea scores before the start of treatment, prior to discharge and after a 4-week stable period. Additionally, the conventional clinical parameters of COPD and quality of life were documented.
  
  
  RESULTS
  The 6-min walk distance was significantly increased from 97 ± 114 m to 290 ± 106 m. After 4 weeks of outpatient treatment in clinically stable patients, the 6-min walk distance fell non-significantly to 270 ± 120 m. The increment in walk distance fell significantly with advancing severity of COPD: from 112 ± 68 m for grade I and II to 56 ± 88 m for grade IV. Resting as well as exertional dyspnoea scores were significantly reduced (resting dyspnoea from 4 to 2 and exertional dyspnoea from 8 to 6).
  
  
  CONCLUSIONS
  We were able to demonstrate that 6-min walk test and dyspnoea scores, but not pulmonary function test, are suitable parameters to assess the course of COPD exacerbations.
authors: Second Medical Clinic, Hospital Martha-Maria Halle-Doelau, Halle, Germany. th.blankenburg@gmx.de
authors: Thomas
authors: T
authors: Blankenburg
authors: Anne
authors: A
authors: Guettel
authors: Christian
authors: C
authors: Busch
authors: Wolfgang
authors: W
authors: Schuette
mesh_terms: D000208:Acute Disease; D000368:Aged; D004185:Disability Evaluation; D004417:Dyspnea / Q000175:diagnosis* / Q000503:physiopathology*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology*; D011788:Quality of Life; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D064232:Visual Analog Scale; D016138:Walking / Q000502:physiology*