Six-minute walking test performance is associated with survival in cirrhotic patients

Table 1 Patients’ characteristics (n = 106), n (%)

Characteristic	n (%) or means ± SD
Gender M/F	59/47 (56/44)
Age (yr)	51 ± 13
BMI (kg/m2)	25.7 ± 4.7
PASP (mmHg)	25.4 ± 8.0
Cirrhosis etiology
Virus	36 (33.9)
Alcohol	32 (30.2)
NASH	8 (7.5)
Others	30 (28.4)
Child-Pugh class n	7.1 ± 1.8
A	23 (21.7)
B	70 (66)
C	13 (12.3)
MELD	11.1 ± 3.1
Previous history of liver related decompensation	76 (73.8)
Hypertension	19 (17.9)
Diabetes	26 (24.5)
Tobacco smoking	12 (11.4)
Beta-blocker use	32 (30.2)
Hepatic decompensation on the day of the test
Ascites	34 (32.1)
(Grade 1, 2, and 3)	(11.3, 17, 5)
Peripheral edema	13 (12.3)
Hepatic encephalopathy	13 (12.3)
(Grade 1, 2, 3, and 4)	(10.4, 1.9, 0, 0)
Hepatocellular carcinoma	5 (4.7)
Patient on the liver transplantation waiting list	35 (33)
Baseline laboratory1
Hemoglobin (mg/dL)	13.1 ± 1.9
Hematocrit (%)	39.3 ± 5.4
Albumin (g/dL)Bilirubin (mg/dL)INR	3.5 ± 0.62.0 ± 1.51.2 ± 0.2
Creatinine (mg/dL)	0.8 ± 0.3
Na (mmol/L)	137.8 ± 2.1
K (mmol/L)	4.1 ± 0.5
Mg (mg/dL)	1.8 ± 0.2
Ca (mmol/L)	1.2 ± 0.1

¹Continuous variables are shown as means ± SD.

Reference range values: Na (136-145); K (3.5-5.0); Mg (1.6-2.6) and Ca (1.15-1.29).

M: Male; F: Female; PASP: Pulmonary arterial systolic pressure.

Table 2 Six minute walking test performance in 106 patients with liver cirrhosis

Variable	6MWD (m)	P	6MWD (%)	P
		(t-test when applicable)		(t-test when applicable)
Mean 6MWD (m)	515 ± 138
Mean 6MWD (%)			0.91 ± 2.3
6MWD according to Child classes
A	570 ± 144		0.97 ± 0.22
B	504 ± 137		0.88 ± 0.21
C	471 ± 115		0.82 ± 0.25
6MWD according to
Liver decompensation
Ascites (w vs wo)	473 ± 20 vs 535 ± 17	0.03	0.86 ± 0.22 vs 0.95 ± 0.21	0.028
Hepatic encephalopathy (w vs wo)	435 ± 34 vs 525 ± 14	0.04	0.87 ± 0.25 vs 0.91 ± 0.21	0.87
History of previous hepatic decompensation (w vs wo)	496 ± 141 vs 571 ± 115	0.02	0.86 ± 0.22 vs 1.02 ± 0.17	0.004
Hospital admission during follow-up (w vs wo)	444 ± 172 vs 531 ± 125	0.01	0.77 ± 0.25 vs 0.92 ± 0.20	0.004
Survival (died vs survived)	423 ± 122 vs 526 ± 137	0.02	0.72 ± 0.21 vs 0.93 ± 0.21

6MWT: Six-minute walking test; 6MWD: Six-minute walking distance; 6MW (%): Predicted distance achieved percentage; w: With; wo: Without.

Table 3 Association between six-minute walking test parameters and unfavorable clinical outcomes (hospital admissions and mortality) using logistic regression models

	Hospital Admission							Mortality
Predictors	Univariate			Multivariate			Univariate				Multivariate
	b	p	OR	b	p	OR	b		p	OR	b	p	OR
Child score	0.74	< 0.01	2.1	0.72	< 0.01	2.05	1.01		< 0.01	2.75	1.03	< 0.01	2.8
6MWD	-0.005	< 0.01	0.99	-0.005	0.24	0.99	-0.007		0.01	0.99	-0.007	0.04	0.99
%6MWD	-0.04	0.01	0.96	-0.03	0.03	0.96	-0.05		0.02	0.95	-0.05	0.03	0.95
6MWD ≤ 444 m	-1.395	0.007	0.3	-1.462	0.01	0.2	-		-	-	-	-	-
6MWD ≤ 387 m	-	-	-	-	-	-	1.659		0.004	5.25	-1.17	0.2	0.31

¹Confidential intervals for odds ratio are not represented but consider adequate for all analysis except forodds ratio.

OR: Odds ratio.