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Choosing an Adequate Test to Determine Fitness for Air Travel in Obese Individuals

Rooney, D. and Herkenrath, S. and Priegnitz, C. and Putzke, M. and Treml, M. and Wenzel, J. and Aeschbach, D. and Randerath, W. (2019) Choosing an Adequate Test to Determine Fitness for Air Travel in Obese Individuals. Chest, 156 (5), pp. 926-932. Elsevier. DOI: 10.1016/j.chest.2019.07.022 ISSN 0012-3692

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Official URL: https://www.sciencedirect.com/science/article/abs/pii/S0012369219314503?via%3Dihub

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/m(2)). 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 URL in elib:https://elib.dlr.de/130490/
Document Type:Article
Title:Choosing an Adequate Test to Determine Fitness for Air Travel in Obese Individuals
Authors:
AuthorsInstitution or Email of AuthorsAuthor's ORCID iD
Rooney, D.daniel.rooney (at) dlr.deUNSPECIFIED
Herkenrath, S.UNSPECIFIEDUNSPECIFIED
Priegnitz, C.UNSPECIFIEDUNSPECIFIED
Putzke, M.UNSPECIFIEDUNSPECIFIED
Treml, M.UNSPECIFIEDUNSPECIFIED
Wenzel, J.UNSPECIFIEDUNSPECIFIED
Aeschbach, D.daniel.aeschbach (at) dlr.deUNSPECIFIED
Randerath, W.UNSPECIFIEDUNSPECIFIED
Date:2019
Journal or Publication Title:Chest
Refereed publication:Yes
Open Access:No
Gold Open Access:No
In SCOPUS:Yes
In ISI Web of Science:Yes
Volume:156
DOI :10.1016/j.chest.2019.07.022
Page Range:pp. 926-932
Publisher:Elsevier
ISSN:0012-3692
Status:Published
Keywords:air travel, hypoxic challenge test, obesity, walk test
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Aeronautics
HGF - Program Themes:air traffic management and operations
DLR - Research area:Aeronautics
DLR - Program:L AO - Air Traffic Management and Operation
DLR - Research theme (Project):L - Human factors and safety in Aeronautics
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine > Sleep and Human Factors Research
Deposited By: Sender, Alina
Deposited On:21 Nov 2019 14:47
Last Modified:30 Sep 2020 18:55

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