Relationship between 6-minute Walk Distance and Risk of Hospitalization from Exacerbation of COPD in One Year at Trang Hospital


  • Poosiri S เวชกรรมฟื้นฟู โรงพยาบาลตรัง


โรคปอดอุดกั้นเรื้อรัง, การนอนโรงพยาบาล, ความเสี่ยง


Objectives: To investigate a relationship between a 6-minute walk distance (6MWD) and a risk of hospitalization in patients with chronic obstructive pulmonary disease (COPD) in one year.

Study design: Retrospective chart review

Setting: Department of Rehabilitation Medicine, Trang Hospital, Trang province

Subjects: Patients with COPD who had a 6-minute walk test (6MWT) done at outpatient rehabilitation clinic between 1st July 2017- 30th April 2018.

Methods: Demographic data, 6MWD and number of admission for acute COPD exacerbation were extracted from the selected medical records. The patients were subsequently divided into two groups: 6MWD < 350 meters and ≥ 350 meters. The risk of hospitalization for exacerbation in one year was calculated and compared between the two groups.

Results: Of the 123 patients, 90.2% were male. The mean age was 70.5 (SD 9.8) years. The mean 6MWD was 381.4 (SD 113.7) meters. During the one year follow up period 31.7% of patients experienced hospitalization from exacerbation of COPD. The mean of hospitalization in group of 6MWD < 350 meters and ≥ 350 meters was 1.2 (SD 1.3) and 0.3 (SD 0.7) times respectively. The group with 6MWD < 350 meters had a higher risk of being admitted to the hospital due to acute exacerbation of COPD than that of the group with 6MWD ≥ 350 meters. The calculated odds ratio was 6.6 at p < 0.001.

Conclusion: Patients with COPD and the 6MWD < 350 meters had 6.6 times risk of hospitalization for treatment of acute COPD exacerbation in one year more than those with the 6MWD at least 350 meters.


1. Global Initiative for Chronic Obstructive Lung Disease. Pocket guide to COPD diagnosis, management and prevention [Internet]. 2017. [Cited 2019 March 25]. Available from:
2. Ministry of Public Health. Strategy and Planning Division. Statistical Thailand [Internet]. 2560. [Cited 2019 April 20]. Available from
3. Thoracic Society of Thailand. Guideline for chronic obstructive pulmonary disease [Internet]. 2560. [Cited 2019 March 25]. Available from:
4. Ministry of Public Health. Non-communicable disease service plan [Internet]. 2560. [Cited 2019 April 20]. Available from: 3&t=3&id=24&n_id=29656&sec=2
5. American Lung Association. Chronic obstructive pulmonary disease [Internet]. [Cited 2019 March 25]. Available from:
6. Zanoria ST, Wallack RZ. Directly measured physical activity as a predictor of hospitalizations in patients with chronic obstructive pulmonary disease. Chron Resp Dis. 2013;10:207-13.
7. Morakami FK, Morita AA, Bisga GW, Felcar JM, Ribeiro M, Furlanetto KC, et al. Can six-minute walk distance predict the occurrence of acute exacerbations of COPD in patients in Brazil. J Bras Pneumol. 2017;43:280-4.
8. Celli B, Tetzlaff K, Criner G, Polkey MI, Sciurba F, Casaburi R, et al. The 6-minute-walk-distance test as a chronic obstructive pulmonary disease stratification tool. Am J Respir Crit Care Med. 2016; 194:1483-93.
9. Kundu A, Marji A, Sarkar S, Saha K, Jash D, Maikap M. Correlation of six minute walk test with spirometric indices in chronic obstructive pulmonary disease patients: a tertiary care hospital experience. J Assoc Chest Physicians. 2015;3:9-13.
10. Harnphadungkit K. 6-Minute Walk Test. J Thai Rehabil Med. 2014; 24:1-4.
11. Casanova C, Cote CG, Marin JM, Torres JP, Jaime AA, Mendez R, et al. The 6-min walking distance: long-term follow up in patients with COPD. Eur Respir J. 2007;29:535-40.
12. Spruit MA, Polkey MI, Celli B, Edwards LD, Watkins ML, Plata VP, et al. Predicting outcomes from 6-minute walk distance in chronic obstructive pulmonary disease. J Am Med Dir Assoc. 2012;13: 291-7.
13. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111-7.
14. Seemungal TA, Donaldson GC, Bhowmik A, Jeffries DJ, Wedzicha JA. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000;161:1608-13.