Poster sessionsThorax 2012;67(Suppl 2):A1-A204 A81Results Of 243 CPET tests performed during this period, 68 (28%) were done to evaluate UB&EI. 38 patients(56%) were obese. Overall, obesity was the sole cause of UB&EI in 22 patients (32%) and was a contributory factor in a further 15 patients (22%). In the obese subgroup, it was the sole cause in 21 patients (55%) and contributory in a further 16 patients (43%). Being overweight (BMI 29) was the sole cause of unexplained breathlessness in 1 non-obese patient. Obesity appeared to be the major contributing factor for UB&EI even when present with other factors. In 23 patients (34%) more than one contributory factor was present (Cardiovascular/ Respiratory/VQ mismatch/physical de-conditioning/functional). Physical de-conditioning was the sole cause in 5 patients (7%) and Hyperventilation in 2 patients (3%). Conclusion While the causes of UB&EI are multi factorial, in our study obesity was a contributory and often key factor in over half the patients. In the obese subgroup, being overweight was the sole factor in over half and played a contributory role in almost all patients. CPET is a useful test to determine specific causes of UB&EI when resting cardio-respiratory tests are non-contributory and can help with reassurance, dietary advice and exercise prescription.

Advances in chemotherapy and radiation oncology notwithstanding, surgery remains the best chance of cure in lung cancer. Pre-operative evaluation is very important to reduce surgery-related mortality and complications. Thoracic surgery scoring system (Thoracoscore) is a recently validated multi-variate instrument with nine parameters and is the first scoring system to predict in-hospital mortality after general thoracic procedures. 1 It was derived from 15,183 patients who underwent thoracic surgery in 59 institutions in Europe. It also seems to predict mid-term mortality after thoracic surgery. 2 Currently, the role of thoracoscore in triaging patients for radical surgery is unclear. The European Respiratory Society (ERS) guidelines 2009 3 recommend that this scoring system should not be used for pre-operative evaluation of individual patients for fitness for lung resection. Instead, it recommends cardiopulmonary exercise testing (CPEX) as the standard test to assess exercise capacity and predict post-operative complications. In

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