Choosing an Adequate Test to Determine Fitness for Air Travel in Obese Individuals
| Autor: | Simon Herkenrath, J. Wenzel, Marcel Treml, Matthias Putzke, Daniel Aeschbach, Winfried Randerath, Christina Priegnitz, Daniel Rooney |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty obesity Critical Care and Intensive Care Medicine 03 medical and health sciences Oxygen Consumption 0302 clinical medicine hypoxic challenge test medicine Humans Oximetry Prospective Studies 030212 general & internal medicine Hypoxia Prospective cohort study Aged Air travel Aged 80 and over COPD Receiver operating characteristic business.industry Altitude walk test Middle Aged Hypoxia (medical) medicine.disease Obesity Comorbidity air travel Dyspnea ROC Curve 030228 respiratory system Physical Fitness Exercise Test Physical therapy Female Analysis of variance medicine.symptom Cardiology and Cardiovascular Medicine business |
| Popis: | Background Air travel is physically demanding and, because obesity is rising, physicians increasingly need to assess whether such patients can fly safely. Our aim was to compare the diagnostic accuracy of two routinely used exercise tests, 50-m walk test and 6-min walk test, and hypoxic challenge testing (HCT) in obese individuals. We further explored the diagnostic potential of perceived dyspnea as measured with the Borg scale because this is often recorded subsequent to walking tests. Methods In this prospective study, we examined 21 obese participants (10 women, age 51 ± 15 [mean ± SD], BMI 36 ± 5 kg/m2). The most prevalent comorbidity was COPD (n = 11). The reference standard for in-flight hypoxia, defined as oxygen saturation below 90%, was established in an altitude chamber. Diagnostic accuracy of each index test was estimated by area under the receiver operating characteristic curve (AUC). Results Of the 21 participants, 13 (9 with COPD) were identified with in-flight hypoxia. HCT was the only test separating the reference groups significantly with AUC 0.87 (95% CI, 0.62-0.96). Neither of the walking tests predicted noticeably above chance level: 50 m walk test had an AUC of 0.63 (0.36-0.84) and 6MWT had an AUC of 0.64 (0.35-0.86). We further observed good prognostic ability of subjective dyspnea assessment when recorded after 6MWT with an AUC of 0.80 (0.55-0.93). Conclusions In-flight hypoxia in obese individuals can be predicted by HCT but not by simple walking tests. |
| Databáze: | OpenAIRE |
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