Postexercise peripheral oxygen saturation after completion of the 6-minute walk test predicts successfully reaching the summit of Aconcagua

Matthew P. Lazio, Jon D. Van Roo, Carlos Pesce, Sanjeev Malik, D. Mark Courtney

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective.- The 6-minute walk test (6MWT) is a single measurement of functional status in patients with cardiovascular disease. It has not been studied at high altitude. We investigate the screening value of 6-minute walk distance (6MWD) and postexercise vital sign (VS) measurements as predictors of successfully reaching the summit or development of acute mountain sickness (AMS) on Aconcagua (6962 m). Methods.- Prospective observational cohort in Aconcagua Provincial Park, Argentina. Adults climbing the normal route who registered with base camp physicians were included. There were no exclusion criteria. VSs were measured before (resting) and after (postexercise) completion of 6MWT while volunteers acclimatized at Plaza de Mulas base camp (4365 m). Volunteers proceeded towards the summit at their own pace and upon descent returned a questionnaire with maximum altitude reached and Lake Louise AMS Self-report Score (LLSelf). Results.- One hundred twenty-four volunteers completed the 6MWT. Sixty-four volunteers (51.6%) completed questionnaires; 56% summited. Median LLSelf was 4 (IQR: 3.06.5). There was no association between any resting or postexercise VS measurements and AMS. However, mean postexercise SpO2 was 80.8% in summiters and 76.4% in nonsummiters, a difference of -4.4% (95% CI: -6.7 to -2.0, p = 0.0005). Postexercise SpO2 < 75% had 97.2% sensitivity and negative likelihood ratio of 0.086 in predicting the outcome of successfully reaching the summit: only one climber with SpO2 < 75% successfully reached the summit. Conclusions.- This study provides the first published data on 6MWD recorded in the field at high altitude. Postexercise SpO2 < 75% may be a useful screening test for predicting the outcome of successfully reaching the summit of Aconcagua.

Original languageEnglish (US)
Pages (from-to)309-317
Number of pages9
JournalWilderness and Environmental Medicine
Volume21
Issue number4
DOIs
StatePublished - Dec 1 2010
Externally publishedYes

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Altitude Sickness
Volunteers
Oxygen
Vital Signs
Argentina
Lakes
Self Report
Cardiovascular Diseases
Physicians
Walk Test
Surveys and Questionnaires

Keywords

  • 6-minute walk test
  • Aconcagua
  • altitude sickness
  • hypoxia
  • mountaineering
  • sensitivity and specificity

ASJC Scopus subject areas

  • Emergency Medicine
  • Public Health, Environmental and Occupational Health

Cite this

Postexercise peripheral oxygen saturation after completion of the 6-minute walk test predicts successfully reaching the summit of Aconcagua. / Lazio, Matthew P.; Van Roo, Jon D.; Pesce, Carlos; Malik, Sanjeev; Courtney, D. Mark.

In: Wilderness and Environmental Medicine, Vol. 21, No. 4, 01.12.2010, p. 309-317.

Research output: Contribution to journalArticle

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abstract = "Objective.- The 6-minute walk test (6MWT) is a single measurement of functional status in patients with cardiovascular disease. It has not been studied at high altitude. We investigate the screening value of 6-minute walk distance (6MWD) and postexercise vital sign (VS) measurements as predictors of successfully reaching the summit or development of acute mountain sickness (AMS) on Aconcagua (6962 m). Methods.- Prospective observational cohort in Aconcagua Provincial Park, Argentina. Adults climbing the normal route who registered with base camp physicians were included. There were no exclusion criteria. VSs were measured before (resting) and after (postexercise) completion of 6MWT while volunteers acclimatized at Plaza de Mulas base camp (4365 m). Volunteers proceeded towards the summit at their own pace and upon descent returned a questionnaire with maximum altitude reached and Lake Louise AMS Self-report Score (LLSelf). Results.- One hundred twenty-four volunteers completed the 6MWT. Sixty-four volunteers (51.6{\%}) completed questionnaires; 56{\%} summited. Median LLSelf was 4 (IQR: 3.06.5). There was no association between any resting or postexercise VS measurements and AMS. However, mean postexercise SpO2 was 80.8{\%} in summiters and 76.4{\%} in nonsummiters, a difference of -4.4{\%} (95{\%} CI: -6.7 to -2.0, p = 0.0005). Postexercise SpO2 < 75{\%} had 97.2{\%} sensitivity and negative likelihood ratio of 0.086 in predicting the outcome of successfully reaching the summit: only one climber with SpO2 < 75{\%} successfully reached the summit. Conclusions.- This study provides the first published data on 6MWD recorded in the field at high altitude. Postexercise SpO2 < 75{\%} may be a useful screening test for predicting the outcome of successfully reaching the summit of Aconcagua.",
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KW - sensitivity and specificity

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