40 Steps to Safety: Can comparing blood oxygen levels before and after a person has walked 40 steps help to decide whether they can be safely discharged from hospital?

Exertional desaturation as a marker of risk – Validation study for the 40-steps-test: A multi-centre prospective observational cohort study

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

ISRCTN

Registry ID

ISRCTN86554504

Enrollment

1000

Registered

2023-08-31

Start date

2020-11-30

Completion date

Unknown

Last updated

2023-09-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

All alert and mobile acutely ill patients considered for discharge to independent care including patients with suspected COVID-19 Signs and Symptoms

Interventions

Performance of the 40-steps-test and measurement of oxygen saturations and pulse rate prior to the test and after completion.

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Patients who are being considered for discharge to independent care 2. Willing and able to give informed consent for participation in the study 3. Independent, stable gait 4. Alert, attentive, coherent and calm

Exclusion criteria

Exclusion criteria: 1. Minor injuries 2. Elective surgery patients 3. Post-operative patients at discharge 4. Requires supplemental oxygen 5. Shortness of breath at rest (i.e. Borg or Numerical Rating Scale >=2) 6. Unstable angina 7. On long-term-oxygen therapy 8. Pregnancy as stated by patient 9. Oxygen saturation 100 bpm 11. Resting respiratory rate >25 bpm 12. ECG with signs of acute ischemia in patients where an ECG has been requested by the treating clinician 13. National Early Warning Score of 5 or more 14. Nursing home residents, or those being transferred to a nursing home or similar care facility

Design outcomes

Primary

Measure	Time frame
Validation of the 40 steps on the spot test as a marker for safe discharge from hospital, assessed by collecting the following information from the participants’ medical records: 1. Change in decision to discharge following the 40 steps test 2. Outcome at 30 days following the test (30-day hospital admission and 30-day mortality)	—

Secondary

Measure	Time frame
Normal values for the 40 steps test challenge in a range of age groups: 1. Oxygen saturation measured by oximeter 2. Heart rate measured by oximeter 3. Breathlessness measured by number of breaths per minute and by using the rating scale for dyspnoea The above will be measured immediately after the 40 steps test and at 2 minutes after ending the test. Baseline values will be collected from medical records	—

Measure

Time frame

Normal values for the 40 steps test challenge in a range of age groups: 1. Oxygen saturation measured by oximeter 2. Heart rate measured by oximeter 3. Breathlessness measured by number of breaths per minute and by using the rating scale for dyspnoea The above will be measured immediately after the 40 steps test and at 2 minutes after ending the test. Baseline values will be collected from medical records

—

Countries

Denmark, Netherlands, United Kingdom, Wales

Contacts

Public ContactChristian P Subbe

christian.subbe@wales.nhs.uk+44(0)1248 384384

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Feb 4, 2026