Post-operative serum lactate measurement and pre-operative fitness as determined by CPET as predictors of mortality after major elective abdominal surgery

Abstract

mographic Batch Service (DBS) and Trust clinical databases. Patients who did not proceed to surgery were excluded from the analysis.There were 41 (4.5%) deaths at 90 dy and 133 (14.5%) at 1 yr. For the V E /VCO 2 slope at a cut-off > 42 the risk of 90 dy and 1 yr mortality was OR (95% CI) 4.8 (2.2,10.7), p < 0.0005 and 2.5 (1.3,4.5), p¼0.004 respectively whilst VE/VCO2 AT > 42 was non-significant for mortality at both 90dy and 1yr. For a cut-off > 34 the OR was significant for both V E /VCO 2 AT and V E /VCO 2 slope at both 90dy and 1yr but V E /VCO 2 slope demonstrated a higher OR. At 90dy this was OR (95% CI) 2.8 (1.4,5.4), p¼.002 for V E /VCO 2 AT and OR (95% CI) 4.1 (2.1,7.7) p<0.0005 for V E /VCO 2 slope. V E /VCO 2 slope potentially offers advantages over V E /VCO 2 AT in identifying patients at increased mortality risk following major abdominal surgery. V E /VCO 2 slope over the whole exercise should be measured alongside V E /VCO 2 AT in patients undergoing preoperative CPET.