Patients’ inability to perform a preoperative cardiopulmonary exercise test or demonstrate an anaerobic threshold is associated with inferior outcomes after major colorectal surgery
dc.contributor.author | Lai, CW | |
dc.contributor.author | Minto, G | |
dc.contributor.author | Challand, CP | |
dc.contributor.author | Hosie, KB | |
dc.contributor.author | Sneyd, John | |
dc.contributor.author | Creanor, Siobhan | |
dc.contributor.author | Struthers, RA | |
dc.date.accessioned | 2013-06-19T11:55:35Z | |
dc.date.accessioned | 2013-06-19T11:56:34Z | |
dc.date.available | 2013-06-19T11:55:35Z | |
dc.date.available | 2013-06-19T11:56:34Z | |
dc.date.issued | 2013-10 | |
dc.identifier.issn | 0007-0912 | |
dc.identifier.issn | 1471-6771 | |
dc.identifier.uri | http://hdl.handle.net/10026.1/1538 | |
dc.description.abstract |
BACKGROUND: Surgical patients with poor functional capacity, determined by oxygen consumption at anaerobic threshold (AT) during cardiopulmonary exercise testing (CPET), experience longer hospital stays and worse short- and medium-term survival. However, previous studies excluded patients who were unable to perform a CPET or who failed to demonstrate an AT. We hypothesized that such patients are at risk of inferior outcomes after elective surgery. METHODS: All patients undergoing major colorectal surgery attempted CPET to assist in the planning of care. Patients were stratified by their test results into Fit (AT ≥ 11.0 ml O2 kg(-1) min(-1)), Unfit (AT < 11.0 ml O2 kg(-1) min(-1)), or Unable to CPET groups (failed to pedal or demonstrate an AT). For each group, we determined hospital stay and mortality. RESULTS: Between March 2009 and April 2010, 269 consecutive patients were screened, and proceeded to bowel resection. Median hospital stay was 8 days (IQR 5.1-13.4) and there were 44 deaths (16%) at 2 yr; 26 (9.7%) patients were categorized as Unable to CPET, 69 (25.7%) Unfit and 174 (64.7%) Fit. There were statistically significant differences between the three groups in hospital stay [median (IQR) 14.0 (10.5-23.8) vs 9.9 (5.5-15) vs 7.1 (4.9-10.8) days, P < 0.01] and mortality at 2 yr [11/26 (42%) vs 14/69 (20%) vs 19/174 (11%), respectively (P < 0.01)] although the differences between Unable and Unfit were not statistically different. CONCLUSIONS: Patients' inability to perform CPET is associated with inferior outcomes after major colorectal surgery. Future studies evaluating CPET in risk assessment for major surgery should report outcomes for this subgroup. | |
dc.format.extent | 607-611 | |
dc.format.medium | Print-Electronic | |
dc.language | en | |
dc.language.iso | eng | |
dc.publisher | Elsevier BV | |
dc.relation.replaces | http://hdl.handle.net/10026.1/1537 | |
dc.relation.replaces | 10026.1/1537 | |
dc.subject | exercise test | |
dc.subject | general surgery | |
dc.subject | length of stay | |
dc.subject | mortality | |
dc.subject | preoperative care | |
dc.subject | risk assessment | |
dc.title | Patients’ inability to perform a preoperative cardiopulmonary exercise test or demonstrate an anaerobic threshold is associated with inferior outcomes after major colorectal surgery | |
dc.type | journal-article | |
dc.type | Journal Article | |
dc.type | Research Support, Non-U.S. Gov't | |
plymouth.author-url | https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000325045400013&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008 | |
plymouth.issue | 4 | |
plymouth.volume | 111 | |
plymouth.publication-status | Published | |
plymouth.journal | British Journal of Anaesthesia | |
dc.identifier.doi | 10.1093/bja/aet193 | |
plymouth.organisational-group | /Plymouth | |
plymouth.organisational-group | /Plymouth/Faculty of Health | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy | |
plymouth.organisational-group | /Plymouth/Research Groups | |
plymouth.organisational-group | /Plymouth/Research Groups/Institute of Health and Community | |
plymouth.organisational-group | /Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED) | |
plymouth.organisational-group | /Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CBBB | |
plymouth.organisational-group | /Plymouth/Users by role | |
dc.publisher.place | England | |
dc.identifier.eissn | 1471-6771 | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.1093/bja/aet193 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.type | Journal Article/Review |