Abstract
Purpose
To assess the prognostic value of the 8-foot-up-and-go test (8-FUGT) in pilot cohort of patients with idiopathic pulmonary fibrosis (IPF).
Methods
Thirty-four patients with IPF (68 ± 8 years) underwent 8-FUGT at baseline and were followed for up to 40 months. Receiver operating characteristics and age-adjusted Cox hazard ratios (HR) were analyzed for 8-FUGT, hospitalizations, and mortality. Correlation coefficients were determined between 8-FUGT and other exercise tests.
Results
8-FUGT ≥ 6.9 s was found to be associated with hospitalization (sensitivity = 77%, specificity = 76%, p = 0.03) and mortality (sensitivity = 91%, specificity = 70% p = 0.008) in patients with IPF. Categorical models demonstrated that 8-FUGT ≥ 6.9 s was associated with 14.1- (p < 0.001) and 55.4-fold (p = 0.001) increased risks for hospitalization and mortality, respectively. In continuous models, for every 1-s slower performance in the 8-FUGT there were 54% [HR = 1.54, 95% CI (1.11–2.15) p = 0.01] increased risk for hospitalization and 94% [HR = 1.94, 95% CI (1.26–2.99) p = 0.003] increased risk for mortality. 8-FUGT was inversely related to 6-min walk distance (r = − 0.61), peak oxygen consumption (r = − 0.58), and peak work rate (r = − 0.72), all p < 0.001.
Conclusions
The 8-FUGT was strongly associated with hospitalizations and mortality in patients with IPF, as well as correlated with established prognostic markers. These novel findings suggest a prognostic value of the 8-FUGT for risk stratification, referral to pulmonary rehabilitation, and considering listing for lung transplantation. 8-FUGT is an inexpensive and practical tool that has prospective for implementation in clinical and research settings in IPF. Future prospective studies should evaluate the effect of changes in 8-FUGT on clinical outcomes.
Trial registration
NCT01499745, Clinicaltrials.gov.
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BV was responsible for study design and conception, data collection, results interpretation, statistical analysis, drafting, writing, and submitting the manuscript. MRK supervising physician of the study was responsible for study design and conception, results interpretation, drafting the article, and revising it critically for important intellectual content. JM was involved in results interpretation, statistical analysis, drafting the article, and revising it critically for important intellectual content. AU and SI participated in results interpretation, statistical analysis, drafting the article, and revising it critically for important intellectual content. JO was involved in study design and conception, results interpretation, statistical analysis, drafting the article, and revising it critically for important intellectual content. All authors have read and approved the manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Vainshelboim, B., Kramer, M.R., Myers, J. et al. 8-Foot-Up-and-Go Test is Associated with Hospitalizations and Mortality in Idiopathic Pulmonary Fibrosis: A Prospective Pilot Study. Lung 197, 81–88 (2019). https://doi.org/10.1007/s00408-018-0189-4
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DOI: https://doi.org/10.1007/s00408-018-0189-4