Universität zu Köln

Rooney, Daniel ORCID: 0000-0002-2966-9483, Herkenrath, Simon, Priegnitz, Christina, Putzke, Matthias, Treml, Marcel, Wenzel, Juergen, Aeschbach, Daniel and Randerath, Winfried (2019). Choosing an Adequate Test to Determine Fitness for Air Travel in Obese Individuals. Chest, 156 (5). S. 926 - 933. AMSTERDAM: ELSEVIER. ISSN 1931-3543

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Abstract

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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rooney, Daniel UNSPECIFIED orcid.org/0000-0002-2966-9483 UNSPECIFIED Herkenrath, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Priegnitz, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Putzke, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Treml, Marcel UNSPECIFIED UNSPECIFIED UNSPECIFIED Wenzel, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Aeschbach, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Randerath, Winfried UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-129408
DOI:	10.1016/j.chest.2019.07.022
Journal or Publication Title:	Chest
Volume:	156
Number:	5
Page Range:	S. 926 - 933
Date:	2019
Publisher:	ELSEVIER
Place of Publication:	AMSTERDAM
ISSN:	1931-3543
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OBSTRUCTIVE PULMONARY-DISEASE; HYPOXIA INHALATION TEST; FLIGHT; HYPOXEMIA; FLY Multiple languages Critical Care Medicine; Respiratory System Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12940