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DOI: 10.1055/s-2006-955941
© Georg Thieme Verlag KG Stuttgart · New York
Prediction of Cardiopulmonary Morbidity after Resection for Lung Cancer: Stair Climbing Test Complications after Lung Cancer Surgery
Publication History
received February 17, 2006
Publication Date:
04 June 2007 (online)
Abstract
Background: The objective of this study was to assess the role of a modified stair climbing test in predicting postoperative cardiopulmonary complications. Methods: A consecutive series of 150 patients who had undergone pulmonary resection for lung carcinoma formed the prospective database of this study. All patients performed a preoperative modified stair climbing test. Univariate and multivariate analyses were performed to identify predictors of postoperative cardiopulmonary complications. Results: With univariate analysis, the patients with complications had a lower pre-exercise and postexercise percentage of oxygen saturation. PaO2 levels were found to be lower and a greater change in oxygen desaturation during exercise was noted. Logistic regression analysis showed that the percent of oxygen saturation pre-exercise and the change in percent of oxygen desaturation during exercise were independent and reliable predictors of cardiopulmonary morbidity. Conclusions: A modified stair climbing test is a safe, economical and simple test capable of predicting cardiopulmonary complications.
Key words
lung cancer - surgery - complications
References
- 1 Boysen P G, Block A J, Moulder P V. Relationship between preoperative pulmonary function tests and complications after thoracotomy. Surg Gynecol Obstet. 1981; 152 813-815
- 2 Harpole D H, DeCamp M M, Daley J. et al . Prognostic models of thirty day mortality and morbidity after major pulmonary resection. J Thorac Cardiovasc Surg. 1999; 117 969-979
- 3 Ribas J, Diaz O, Barbera J A. et al . Invasive exercise testing in the evaluation of patients at high risk for lung resection. Eur Respir J. 1998; 12 1429-1435
- 4 Ninnan M, Sommers E, Landrenau R J. et al . Standardized exercise oximetry predicts postpneumonectomy outcome. Ann Thorac Surg. 1997; 64 328-333
- 5 Markos J, Mullan B P, Hillman D R. et al . Preoperative assessment as a predictor of mortality and morbidity after lung resection. Am Rev Respir Dis. 1989; 139 902-910
- 6 Zibrak J D, O'Donnell C R, Marton K. Indications for pulmonary function testing. Ann Intern Med. 1990; 112 763-771
- 7 Kearney D C, Lee T H, Reilly J J, DeCamp M M, Sugarbaker D J. Assessment of operative risk in patients undergoing lung resection. Importance of predicted pulmonary function. Chest. 1994; 105 753-759
- 8 Brunelli A, Monteverde M, Refai M, Fianchini A. Stair climbing test as a predictor of cardiopulmonary complications after pulmonary lobectomy in the elderly. Ann Thorac Surg. 2004; 77 266-270
- 9 Toker A, Bayrak Y, Tanju S. et al . Invasive staging of superior mediastinum in non-small cell lung cancer patients with specific indications. Interact Cardiovasc Thorac Surg. 2003; 2 472-476
- 10 Olsen G N, Bolton J WR, Weiman D S, Hornung C A. Stair climbing as an exercise test to predict the postoperative complications of lung resection: two years experience. Chest. 1991; 99 587-590
- 11 Rao V, Todd T RJ, Kuus A, Buth K J, Pearson F G. Exercise oxymetry versus spirometry in the assessment of risk prior to lung resection. Ann Thorac Surg. 1995; 60 603-609
- 12 Brunelli A, Refai M A, Monteverde M, Borri A, Salati M, Fianchini A. Predictors of exercise oxygen desaturation following major lung resection. Eur J Cardiothorac Surg. 2003; 24 145-148
- 13 Escurrou P J, Delaperche M F, Visseaux A. Relaibility of pulse oxymetry during exercise in pulmonary patients. Chest. 1990; 97 635-638
- 14 Wagner P D. Ventilation-perfusion matching during exercise. Chest. 1992; 101 192-198
- 15 Bolliger C T, Jordan P, Soler M. et al . Exercise capacity as a predictor of postoperative complications in lung resection candidates. Am J Respir Crit Care Med. 1995; 151 1472-1480
- 16 Brutsche M, Spilopoulos A, Bolliger C T, Licker M, Frey J G, Tschopp J M. Exercise capacity and extent of resection as predictors of surgical risk in lung cancer patients. Eur Respir J. 2000; 15 828-832
- 17 Brunelli A, Sabbatini A, Xiume F. et al . Inability to perform maximal stair climbing test before lung resection: a propensity score analysis on early outcome. Eur J Cardiothorac Surg. 2005; 27 367-372
- 18 Girish M, Taryner Jr E, Damman O, Pinto-Plata V, Celli P. Symptom limited stair climbing test as a predictor of cardiopulmonary complications after high risk surgery. Chest. 2001; 120 1147-1151
- 19 Bolliger C T, Koegelenberg C F, Kendal R. Preoperative assessment for lung cancer. Curr Opin Pulm Med. 2005; 11 301-306
Dr. Serhan Tanju
Department of Thoracic Surgery
Istanbul University
Istanbul Medical School
Tasmektep sok
Cinarli Apt 34/5
34730 Goztepe, Istanbul
Turkey
Phone: + 90 53 23 37 66 71
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Email: drstanju@hotmail.com