Performance in 6-min walk test in prediction of post-operative pulmonary complication in major oncosurgeries: A prospective observational study

Sathyaprasad, Sethu Lekshmi; Thomas, Mary Ann; Philip, Frenny Ann; Krishna, K M Jagathnath

doi:10.4103/ija.ija_533_19

Cited by 16 publications

(9 citation statements)

References 26 publications

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“…These pulmonary and cardiopulmonary tests are successfully used in risk stratification also in other surgical procedures: cardiac [ 22 ], cardiovascular [ 23 ] or abdominal [ 24 ]. The 6MWT is also a valuable method of preoperative risk assessment in oncological surgery [ 25 ], esophagectomy [ 26 ] or thymectomy [ 27 ]. The thresholds mentioned were similar (390–498 m) to those identified in patients before pulmonary resection.…”

Section: Discussionmentioning

confidence: 99%

500 Meters Is a Result of 6-Minute Walk Test Which Differentiates Patients with High and Low Risk of Postoperative Complications after Lobectomy—A Validation Study

Marjański

Wnuk

Dziedzic

et al. 2021

JCM

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The 6-minute walk test (6MWT) is a simple method of identifying patients with a high risk of postoperative complications. In this study, we internally validated the previously obtained threshold value of 500 m in the 6MWT as differentiating populations with a high and a low risk of postoperative complications after a lobectomy. Between November 2011 and November 2016, 624 patients who underwent a lobectomy and performed the 6MWT preoperatively entered this study. We compared the complication rates of two groups of patients—those who walked more than and those who walked less than 500 m. The patients who did not reach the distance of 500 m in the 6MWT were older (70 vs. 63 years p < 0.001), had worse pulmonary function tests (FEV1% 84 vs. 88 p = 0.041) and had a higher Charlson Comorbidity Index (p < 0.001). The patients who had a worse result in the 6MWT had a higher complication rate (52% vs. 42% p = 0.019; OR: 1.501 95% CI: 1.066–2.114) and a longer median postoperative hospital stay (7 vs. 6 days p = 0.010). In a multivariate analysis, the result of the 6MWT and pack-years proved to independently influence the risk of postoperative complications. This internal validation study confirms that 500 m is a result of the 6MWT which differentiates patients with a higher risk of postoperative complications and a prolonged hospital stay after a lobectomy.

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Section: Discussionmentioning

confidence: 99%

500 Meters Is a Result of 6-Minute Walk Test Which Differentiates Patients with High and Low Risk of Postoperative Complications after Lobectomy—A Validation Study

Marjański

Wnuk

Dziedzic

et al. 2021

JCM

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“…[ 16 , 17 , 11 , 13 ] This test is a valid measurement of health in cancer patients, with correlation with VO 2 peak ( r = 0.67) and perceived physical function (EORTC QLQ-C30 physical function subscale). [ 25 ] It is a predictor of post-operative pulmonary complications for cancer patients undergoing elective abdominal or thoracic oncosurgery under general anesthesia with a cut-off at 390 m. [ 26 ] Only one study [ 11 ] measured VO 2 and the six-minute-walk test during two time periods (post-NACRT to pre-surgery and pre-NACRT to pre-surgery). These two measurements evolve in the same direction; however, only the six-minute-walk test during pre-NACRT to pre-surgery changed significantly, rendering any correlation hazardous.…”

Section: Discussionmentioning

confidence: 99%

Physical activity programmes for patients undergoing neo-adjuvant chemoradiotherapy for rectal cancer

Latrille¹,

Buchs

Ris

et al. 2021

Medicine

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Background: Patients diagnosed with localized rectal cancer should undergo Neoadjuvant Radio-Chemotherapy (NACRT) followed, a few weeks later, by surgical resection. NACRT is known to cause significant decline in the physical and psychological health of patients. This literature review aims to summarize the effects of a prehabilitation programme during and/or after NACRT but before surgery. Methods: Articles included in this review have been selected by two independent researchers on Pubmed, Google Scholar, and Cochrane databases with the following terms: “Rectal Cancer AND Physical Activity” and “Exercise AND Rectal Cancer.” Results: We obtained 560 articles. We selected 12 of these, representing 7 series but only one randomized study, constituting 153 patients in total. Most studies included have considerable variation in their prehabilitation programmes, in terms of supervision, training content, frequency, intensity, duration, and temporality, in regard to NACRT and surgery. Implementing a prehabilitation programme during NACRT seems feasible and safe, with adherence ranging from 58% to 100%. VO 2max (maximal oxygen consumption during incremental exercise) was improved in three of the studies during the prehabilitation programme. No significant difference in the step count, 6-minute-walk test, or quality of life was seen. Conclusions: Prehabilitation programmes during NACRT for localized rectal cancer patients are safe and feasible; however, due to considerable variation in the prehabilitation programmes and their small size, impact on fitness, quality of life, and surgical outcome are unknown. Larger randomized studies are needed.

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“…A cut-off six-minute walk distance (6MWD) of less than 390 m was found to correlate with longer duration of hospital stay and ICU stay in thoracic and abdominal onco-surgical patients above 60 years old. 23 Secondary outcomes included length of hospital stay after surgery; postoperative morbidity (classified according to the Clavien-Dindo criteria 24 ; 30-day readmission; discharge destination and the Modified Barthel Index (MBI), a 100-point rating scale which evaluates a patient's independence in 10 kinds of Activities of daily living (ADL) such as feeding, moving from wheelchair to bed, and return, grooming, transferring to and from a toilet, bathing, walking on a level surface, going up, and down stairs, dressing, and continence of bowels, and bladder. 25…”

Section: Outcome Measuresmentioning

confidence: 99%

Recovery of surgery in the elderly (ROSE) program: The efficacy of a multi‐modal prehabilitation program implemented in frail and pre‐frail elderly undergoing major abdominal surgery

Chow,

Teo,

Acharyya

et al. 2023

World j. surg.

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BackgroundMajor abdominal surgery is associated with a high rate of post‐operative complications with increased risk of adverse surgical outcomes due to the presence of frailty. This study aims to evaluate the effectiveness of the multimodal Recovery of Surgery in the Elderly (ROSE) prehabilitation program with supervised exercise in mitigating postoperative functional decline when compared to standard care.MethodThe ROSE program enrolled ambulant patients who were 65 years and above, had a Clinical Frailty Scale score of 4 or more and were planned for major abdominal surgery. Participation in supervised exercise sessions before surgery were compared with standard physiotherapy advice. The primary outcome was 6‐min walk test (6MWT) distance assessed at baseline, after prehabilitation and 30 days follow‐up after surgery. Secondary outcomes included physical performance, length of hospital stay and postoperative morbidity.ResultsData from 74 eligible patients, 37 in each group, were included. Median age was 78 years old. Forty‐two patients (22 in Prehab group and 20 in control group) with complete 6MWT follow‐up data at 30 days follow‐up were analysed for outcomes. Most patients underwent laparoscopic surgery (63.5%) and almost all of the surgeries were for abdominal malignancies (97.3%). The Prehab group had an increase in 6MWT distance at the 30‐day follow up, from a baseline mean (SD) of 277.4 (125) m to 287.6 (143.5) m (p = 0.415). The 6MWT distance in the control group decreased from a baseline mean (SD) of 281.7 (100.5) m to 260.1 (78.6) m at the 30‐day follow up (p = 0.086). After adjusting for baseline 6MWT distance and frailty score, the Prehab group had significantly higher 6MWT distance at 30‐day follow‐up than control (difference in adjusted means 41.7 m, 95% confidence interval 8.7–74.8 m, p = 0.015). There were no significant between‐group differences in the secondary outcomes.ConclusionA multimodal prehabilitation program with supervised exercise within a short time frame can improve preoperative functional capacity and maintain baseline functional capacity in frail older adults undergoing major abdominal surgery.

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Performance in 6-min walk test in prediction of post-operative pulmonary complication in major oncosurgeries: A prospective observational study

Cited by 16 publications

References 26 publications

500 Meters Is a Result of 6-Minute Walk Test Which Differentiates Patients with High and Low Risk of Postoperative Complications after Lobectomy—A Validation Study

500 Meters Is a Result of 6-Minute Walk Test Which Differentiates Patients with High and Low Risk of Postoperative Complications after Lobectomy—A Validation Study

Physical activity programmes for patients undergoing neo-adjuvant chemoradiotherapy for rectal cancer

Recovery of surgery in the elderly (ROSE) program: The efficacy of a multi‐modal prehabilitation program implemented in frail and pre‐frail elderly undergoing major abdominal surgery

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