ADL: Feeding Transfer Dressing Bathing IADL: Shopping Transportation Table1 Spector-KatzIndex * ADL-IADLisevaluatedbythesum ofeachscore(0:totaly dependent,6:totalyindependent) Table2 Generalcharacteristicsofthepatients Age(years) Male/Female Height(cm) BMI MRCscale BDIfocalscore GOLD stage PaO2 (Torr) PaCO2 (Torr) VC (ml) VC (% predicted) FEV1 (ml) FEV1 (% predicted) FEV1/FVC (%) 6MWD (m) ΔSpO2(%) Borgscaleafterthe6-minutewalk COPD (n=111) 70± 7 104:7 161± 7 19.7± 3.0 1-7,2-23,3-40,4-40,5-1 6.7± 1.9 I-2,I-21, I-45,IV-43 74.7± 11.1 *26caseswerebreathingoxygen. 43.7± 7.4 2,580± 840 81.5± 21.1 990± 480 37.3± 15.7 43.3± 11.2 368± 90-5.2± 4.2 3.9± 2.0 non-copd (n=93) 69± 6 69:24 159± 8 20.2±3.8 1-1,2-15,3-34,4-43 6.1±1.7 76.2± 10.8 *34caseswerebreathingoxygen. 47.0± 8.4 1,740± 790 58.1± 23.6 1,080± 570 41.2± 19.8 68.2± 18.5 352± 90-5.7± 4.7 4.4± 2.2 BMI:bodymassindex,BDI:BaselineDyspneaIndex,VC:vitalcapacity,FEV1:forcedexpiratoryvolumein1second, FVC:forcedvitalcapacity,6MWD:6-minutewalkingdistance,Δ SpO2:oxygendesaturationduringthe6-minutewalk.
Fig.1 ADL-IADLscore A:COPD group,b:non-copd group
Table3 Accuracyindeterminingthelevelthreerespiratoryhandicapsusingthecurrentcriteria A.A lcases 38 39 77 11 116 127 49 155 204 B.COPD 20 19 39 5 67 72 25 86 111 C.non-COPD 18 20 38 6 49 55 24 69 93 D.Interstitiallungdisease 4 0 4 2 13 15 6 13 19 Fig.2 SimplelogisticregressioncurvesshowingtherelationbetweenADL-IADLscoreandFEV1Index (A),and6-minutewalkingdistance(B)inpatientswithCOPD. TheY-axisindicatestheprobabilityofanADL-IADLscoreof4orless.Whenthe6-minutewalkingdistanceis270m,theprobabilityofanADL-IADLscoreof4orlessis50%.
Fig.3 Cross-tableanalysesbetweenADL-IADLscoreandGOLD stage(a),supplementaloxygenuse(b), andmrcscale(c)inpatientswithcopd.
Table4 MultivariatelogisticregressionmodelestimatinginpatientswithCOPD from thethreeselectedparameters Estimation SD χ 2 p 95% CI, upperlimitlowerlimit Oddsratio Intercept -3.108 0.881 5.73 0.0167-4.932-1.422 MRCgrade(1-3/4,5) 1.246 0.638 3.81 0.0509-0.005 2.538 3.475 6MWD (270m) -0.830 0.726 1.31 0.2527-2.280 0.609 0.436 Supplementaloxygen(+ /-) 2.617 0.602 18.89 <0.001 1.476 3.862 13.689 p< 0.0001,R 2 =0.341 Abbreviationsareshownintable1. Fig.4 SimplelogisticcurvesshowingtherelationbetweenADL-IADLscoreandFEV1index(A),and6- minutewalkingdistance(b)in patientswithnon-copd lungdisease. Y-axisindicatestheprobabilityofanADL-IADLscoreof4orless.When6-minutewalkingdistanceis255 m,theprobabilityofadl-iadlscoreof4orlessis50%. Fig.5 Cross-tableanalysesbetweenADL-IADLscoreandsupplementaloxygenuse(A),andMRCscale (B)inpatientswithnon-COPD lungdisease.
Table5 Multivariatelogisticregressionmodelestimatinginpatientswithnon-COPD lungdiseasefrom thethreeselectedparameters Estimation SD χ 2 p 95% CI, upperlimit lowerlimit Oddsratio Intercept -2.638 1.119 5.55 0.0185-5020 -0.481 MRCgrade(1-3/4,5) 2.650 0.8258 10.32 0.0013 1.201 4.589 14.148 6MWD (255m) -0.801 0.801 1.00 0.3175-2.504 0.723 0.449 Supplementaloxygen(+ /-) 1.083 0.613 3.12 0.0776-0.114 2.314 2.952 p< 0.0001,R 2 =0.328 Fig.6 SimplelogisticcurvesshowingtherelationbetweenADL-IADLscoreandFEV1Index(A),and6- minutewalkingdistance(b)inpatientswithinterstitiallungdisease. TheY-axisindicatestheprobabilityofanADL-IADLscoreof4orless.When6-minutewalkingdistance is280m,theprobabilityofanadl-iadlscoreof4orlessis50%. Fig.7 ROCcurves,FEV1Index(A)and6-minutewalkingdistance(B)
Table6 Accuracyindeterminingthelevelthreerespiratoryhandicapusingthenew criteria A.A lcases 40 30 70 9 125 134 49 155 204 B.COPD 18 15 33 7 71 78 25 86 111 C.non-COPD 22 15 37 2 54 55 24 69 93 D.Interstitiallungdisease 6 1 7 0 12 12 6 13 19 Table7 Predictiveabilityofthecurrentandnew criteriaforadl Sensitivity Specificity PPV NPV Overalaccuracy A lcases currentcriteria 77.6 74.8 46.4 91.3 75.5 new criteria COPD 81.6 80.7 57.1 93.3 80.9 currentcriteria 80.0 77.9 51.3 93.1 78.4 new criteria Non-COPD 72.0 82.6 54.6 91.0 80.2 currentcriteria 75.0 71.0 47.4 89.1 72.0 new criteria Interstitiallungdisease 91.7 78.3 56.5 96.4 81.7 currentcriteria 66.7 100 100 86.7 89.5 new criteria 100 92.3 85.7 100 94.7 PPV:positivepredictivevalue,NPV:negativepredictivevalue