Volume 22 Issue 2
Feb.  2024
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YANG Lulu, SHI Minghui, HE Jiaze, QUMU Shiwei, YANG Ting. Study on the value of the DOSE index in assessing impaired exercise tolerance in community patients with stable chronic obstructive pulmonary disease[J]. Chinese Journal of General Practice, 2024, 22(2): 273-276. doi: 10.16766/j.cnki.issn.1674-4152.003382
Citation: YANG Lulu, SHI Minghui, HE Jiaze, QUMU Shiwei, YANG Ting. Study on the value of the DOSE index in assessing impaired exercise tolerance in community patients with stable chronic obstructive pulmonary disease[J]. Chinese Journal of General Practice, 2024, 22(2): 273-276. doi: 10.16766/j.cnki.issn.1674-4152.003382

Study on the value of the DOSE index in assessing impaired exercise tolerance in community patients with stable chronic obstructive pulmonary disease

doi: 10.16766/j.cnki.issn.1674-4152.003382
Funds:

 82200051

 2021-I2M-1-049

  • Received Date: 2023-03-23
    Available Online: 2024-03-27
  •   Objective  This study aims to explorea method for primary healthcare units to assess exercise endurance impairment in patients with chronic obstructive pulmonary disease (COPD) using the DOSE index as the core indicator. Additionally, the study aims to determine the critical value of this indicator for predicting exercise endurance impairment in patients with COPD.  Methods  A total of 117 stable COPD patients who were monitored at the China-Japan Friendship Hospital from September 2019 to April 2022 were included in the retrospective analysis. Patients with a six-minute walk distance (6MWD) of less than 350 m were determined to be exercise tolerance. Information on lung function, the modified medical research council (mMRC), smoking status, and acute exacerbations in the previous year was calculate the DOSE index for each patient. Lung function, 6MWD, mMRC scores, and DOSE index were compared between the two groups divided based on 6MWD. The relationship between 6MWD and the DOSE index was investigated using Spearman's correlation analysis; Finally, the effectiveness of the DOSE index in assessing impaired exercise tolerance in COPD patients was analyzed using a receiver operating characteristic (ROC) Curve.  Results  A total of 117 patients with stable COPD were included in this study. The mean 6MWD was (416.94±117.16) m and the mean DOSE index was 3(1, 5) points. Among the participants, 29 had a 6MWD < 350 m, while 88 had a 6MWD ≥350 m. Significant differences were observed between these two groups in terms of age, FVC%pred, FEV1%pred, 6MWD, mMRC score, and DOSE index. Notably, there was a strong inverse relationship between the DOSE index and 6MWD (r=-0.456, P < 0.001). Physicians should be particularly vigilant about impaired exercise tolerance in COPD patients.  Conclusion  The DOSE index, with a predictive threshold of 5 points, exhibits a strong and negative correlation with 6MWD, making it a valuable tool in assessing impaired exercise tolerance among COPD patients. Its simplicity and ease of administration make the DOSE index suitable for implementation in primary healthcare settings.

     

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  • [1]
    Global Initiative for Chronic Obstructive Lung Disease(GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease 2020 report[EB/OL]. (2020-11-01)[2023-01-15]. https://goldcopd.org/wp-content/uploads/2019/12/GOLD-2020-FINAL-ver1.2-03Dec19_WMV.pdf.
    [2]
    WANG C, XU J Y, YANG L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health[CPH] study): a national cross-sectional study[J]. Lancet, 2018, 391(10131): 1706-1717. doi: 10.1016/S0140-6736(18)30841-9
    [3]
    ZHOU M G, WANG H D, ZENG X Y, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 394(10204): 1145-1158. doi: 10.1016/S0140-6736(19)30427-1
    [4]
    ATS Committee on Proficiency standards for clinical pulmonary function laboratories. ATS statement: guidelines for the six-minute walk test[J]. Am J Respir Crit Care Med, 2002, 166(1): 111-117. doi: 10.1164/ajrccm.166.1.at1102
    [5]
    中华医学会心血管病学分会, 中国康复医学会心肺预防与康复专业委员会, 中华心血管病杂志编辑委员会. 六分钟步行试验临床规范应用中国专家共识[J]. 中华心血管病志, 2022, 50(5): 432-442.

    Chinese Society of Cardiology, Chinese Medical Association, Professional Committee of Cardiopulmonary Prevention and Rehabilitation of Chinese Rehabilitation Medical Association, Editorial Board of Chinese Journal of Cardiology. Chinese expert consensus on standardized clinical application of 6-minute walk test[J]. Chinese Journal of Cardiology, 2022, 50(5): 432-442.
    [6]
    AGARWALA P, SALZMAN S H. Six-minute walk test: clinical role, technique, coding, and reimbursement[J]. Chest, 2020, 157(3): 603-611. doi: 10.1016/j.chest.2019.10.014
    [7]
    CELLI B R, COTE C G, MARIN J M, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease[J]. N Engl J Med, 2004, 350(10): 1005-1012. doi: 10.1056/NEJMoa021322
    [8]
    王辰, 迟春花, 陈荣昌, 等. 慢性阻塞性肺疾病基层诊疗指南(2018年)[J]. 中华全科医师杂志, 2018, 17(11): 856-870. https://www.cnki.com.cn/Article/CJFDTOTAL-JSWB202003051.htm

    WANG C, CHI C H, CHEN R C, et al. Guideline for primary care of chronic obstructive pulmonary disease (2018)[J]. Chinese Journal of General Practitioners, 2018, 17(11): 856-870. https://www.cnki.com.cn/Article/CJFDTOTAL-JSWB202003051.htm
    [9]
    JONES R C, DONALDSON G C, CHAVANNES N H, et al. Derivation and validation of a composite index of severity in chronic obstructive pulmonary disease: the DOSE Index[J]. Am J Respir Crit Care Med, 2009, 180(12): 1189-1195. doi: 10.1164/rccm.200902-0271OC
    [10]
    任帅, 鞠帅, 霍建民. 生物标志物及评分在慢性阻塞性肺疾病诊治中的研究进展[J]. 临床肺科杂志, 2023, 28(6): 942-945. https://www.cnki.com.cn/Article/CJFDTOTAL-LCFK202306026.htm

    REN S, JU S, HUO J M. Research progress on biomarkers scores in the diagnosis and treatment of chronic obstructive pulmonary disease[J]. Journal of Clinical Pulmonary Medicine, 2023, 28(6): 942-945. https://www.cnki.com.cn/Article/CJFDTOTAL-LCFK202306026.htm
    [11]
    ATHLIN A, GIEZEMAN M, HASSELGREN M, et al. Prediction of mortality using different COPD risk assessments-a 12-year follow-up[J]. Int J Chron Obstruct Pulmon Dis, 2021, 16: 665-675. DOI: 10.2147/COPD.S282694.
    [12]
    CORLATEANU A, PLAHOTNIUC A, CORLATEANU O, et al. Multidimensional indices in the assessment of chronic obstructive pulmonary disease[J]. Respir Med, 2021, 185: 106519. DOI: 10.1016/j.rmed.2021.106519.
    [13]
    张明科, 张琼, 李荣硕. 稳定期COPD患者肺功能与DOSE指数及6MWT相关性研究[J]. 临床医学研究与实践, 2017, 2(16): 13-14, 17. https://www.cnki.com.cn/Article/CJFDTOTAL-YLYS201716004.htm

    ZHANG M K, ZHANG Q, LI R S. Study on correlation between lung function with DOSE and 6MWT in patients with stable COPD[J]. Clinical Research and Practice, 2017, 2(16): 13-14, 17. https://www.cnki.com.cn/Article/CJFDTOTAL-YLYS201716004.htm
    [14]
    STANOJEVIC S, KAMINSKY D A, MILLER M R, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests[J]. Eur Respir J, 2022, 60(1): 2101499. DOI: 10.1183/13993003.01499-2021.
    [15]
    BESTALL J C, PAUL E A, GARROD R, et al. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease[J]. Thorax, 1999, 54(7): 581-586. doi: 10.1136/thx.54.7.581
    [16]
    XIANG X Y, HUANG L H, FANG Y, et al. Physical activity and chronic obstructive pulmonary disease: a scoping review[J]. BMC Pulm Med, 2022, 22(1): 301. doi: 10.1186/s12890-022-02099-4
    [17]
    慢性阻塞性肺疾病中西医结合管理专家共识写作组. 慢性阻塞性肺疾病中西医结合管理专家共识(2023版)[J]. 中国全科医学, 2023, 26(35): 4359-4371. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202335002.htm

    Expert Consensus Writing Group of Integrated Traditional Chinese and Western Medicine Management for Chronic Obstructive Pulmonary Disease. Expert consensus on integrated traditional Chinese and western medicine management for chronic obstructive pulmonary disease(2023 Edition)[J]. Chinese General Practice, 2023, 26(35): 4359-4371. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202335002.htm
    [18]
    MOTEGI T, JONES R C, ISHⅡ T, et al. A comparison of three multidimensional indices of COPD severity as predictors of future exacerbations[J]. Int J Chron Obstruct Pulmon Dis, 2013, 8: 259-271.
    [19]
    JONES R C, PRICE D, CHAVANNES N H, et al. Multi-component assessment of chronic obstructive pulmonary disease: an evaluation of the ADO and DOSE indices and the global obstructive lung disease categories in international primary care data sets[J]. NPJ Prim Care Respir Med, 2016, 26: 16010. DOI: 10.1038/npjpcrm.2016.10.
    [20]
    陶燕霞, 杨又力, 秦善春, 等. 慢性阻塞性肺疾病患者自我管理水平与DOSE指数的相关性[J]. 广东医学, 2019, 40(14): 2027-2031. https://www.cnki.com.cn/Article/CJFDTOTAL-GAYX201914011.htm

    TAO Y X, YANG Y L, QIN S C, et al. The correlation of self-management and DOSE index among patients with chronic obstructive pulmonary disease[J]. Guangdong Medical Journal, 2019, 40(14): 2027-2031. https://www.cnki.com.cn/Article/CJFDTOTAL-GAYX201914011.htm
    [21]
    谭亚芬, 梅牧, 董素素, 等. 稳定期慢性阻塞性肺疾病患者DOSE指数与呼出气一氧化氮相关性分析[J]. 中国现代医药杂志, 2022, 24(8): 37-39. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHTY202208008.htm

    TAN Y F, MEI M, DONG S S, et al. Analysis of the correlation between DOSE index and exhaled nitric oxide in patients with stable chronic obstructive pulmonary disease[J]. Modern Medicine Journal of China, 2022, 24(8): 37-39. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHTY202208008.htm
    [22]
    薛佳丽, 芦鸿雁, 余芳, 等.老年慢性阻塞性肺疾病患者疲劳感知与应对体验的质性研究[J].中华全科医学, 2023, 21(5):792-796. doi: 10.16766/j.cnki.issn.1674-4152.002985

    XUE J L, LU H Y, YU F, et al. Perceived fatigue and coping experience in elderly patients with chronic obstructive pulmonary disease: a qualitative study[J].Chinese Journal of General Practice, 2023, 21(5):792-796. doi: 10.16766/j.cnki.issn.1674-4152.002985
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