Cardiopulmonary exercise testing predicts 5 yr survival after major surgery

Abstract

Multivariate analysis and model generation techniques can be applied to CPET data to predict 5 yr survival after major surgery more accurately than is possible with single variable analysis.

An evaluation of the validity of the pre‐operative oxygen uptake efficiency slope as an indicator of cardiorespiratory fitness in elderly patients scheduled for major colorectal surgery

“…Although oxygen uptake efficiency slope values were found to be strongly correlated with peak oxygen uptake and the ventilatory anaerobic threshold, the small intra-individual differences in maximal and submaximal values might limit the clinical utility of this measure; this requires further research. Future research should also address the prognostic value of the oxygen uptake efficiency slope for different postoperative outcomes in major abdominal surgery, as only one study [32] evaluated the predictive value of the oxygen uptake efficiency slope; this focused on mortality. From the latter study, it is unclear whether the authors normalised absolute oxygen uptake efficiency slope values for body mass, which we believe is necessary, just as with peak oxygen uptake and the ventilatory anaerobic threshold.…”

“…One such parameter, the oxygen uptake efficiency slope (OUES), has been reported to have prognostic value in predicting major cardiac events and mortality in patients with heart failure and coronary artery disease [14][15][16][17]. To the best of our knowledge, only one study investigated the predictive value of the oxygen uptake efficiency slope for a 5-year survival period after a major surgery, and concluded that it did not appear to be a strong predictor of mortality [32]. Baba et al [18] introduced and validated a logarithmic transformation of the minute ventilation over the entire exercise period, resulting in a linear relationship between the minute ventilation and oxygen uptake during the entire, and especially the last part, of the cardiopulmonary exercise test.…”

“…However, the validity of it as an effort-independent alternative measure of pre-operative cardiorespiratory fitness, and its ability to predict postoperative outcomes, are unknown. To the best of our knowledge, only one study investigated the predictive value of the oxygen uptake efficiency slope for a 5-year survival period after a major surgery, and concluded that it did not appear to be a strong predictor of mortality [32]. Therefore, we aimed to investigate the validity of the oxygen uptake efficiency slope as an effort-independent indicator of cardiorespiratory fitness in elderly patients scheduled for major colorectal surgery, by correlating it with peak oxygen uptake and the ventilatory anaerobic threshold, and assessing its stability throughout the last part of the cardiopulmonary exercise test.…”

Cardiopulmonary Exercise Capacity and Preoperative Markers of Inflammation

“…Poor exercise capacity in surgical patients, as measured objectively by preoperative cardiopulmonary exercise [6–12], is associated with poorer postoperative outcomes—including infection—following surgery [13]. Plausible mechanisms that explain the link between poor exercise capacity and poorer postoperative outcomes remain underexplored.…”

The impact of cardiopulmonary exercise testing on patients over the age of 80 undergoing elective colorectal cancer surgery

“…The AT has been extensively investigated, and the findings in the present study of a worse outcome at a lower AT is in keeping with previous work. A lower AT is associated with a longer overall LOS [7,9,12,[18][19][20], increased incidence of adverse cardiac events [3] and poorer overall survival [6,[8][9][10]. Several other studies have also found an increased incidence of severe complications in patients who have a poor performance on CPET [7,12,[20][21][22][23].…”