Cardiopulmonary exercise test accurately prognoses risk of postoperative complications in patients undergoing lung resection in good functional status

doi:10.12047/j.cjap.0094.2021.124

Abstract

Abstract: Objective: To explore the value of predicting accurately the risk of complications after thoracoscopic lung resection by preoperative CPET index. Methods: Selected 448 patients who completed CPET with static pulmonary function test (PFT) before operation, followed up to discharge after operation, and were divided into groups according to the presence or absence of complications: 418 cases had no complications and 30 cases had complications (including 1 death). Calculate peak oxygen uptake (Peak VO2) and other core indicators, compare the similarities and differences between patients with and without complications, and calculate the best cut value and odds ratio (OR). Results: ①In this study, there were 184 males and 264 females, aged (54±12) (16~79) years old, 85 cases with smoking, 23 cases with lymph node metastasis, 68 cases with hypertension, 45 cases with diabetes. Peak VO2 and Peak WR are respectively (93.31±17.73)(44~158)%pred and (99.70±22.93)(53~179)%pred. FVC, VC and FEV₁/FVC are respectively (99.46±15.60)(42~150)%pred, (101.58±15.77)(44~148) %pred and (98.36±9.27)(52~134) %pred. 2There are significant differences(P<0.01) in gender, age, smoking history, lymph node metastasis and core indicators of Peak VO2 (%pred), Peak WR (%pred), FVC, VC, Rest SBP and Peak SBP . There are also differences(P<0.05) in Peak VO₂ (ml/(min·kg)), Peak VO₂/HR (%pred), VE/VCO₂ slope, VE/ VCO₂@AT, Peak HR (bmp), RER, FEV₁ and fasting blood glucose. No difference in other indicators. ③OR are respectively 4.24 and 3.72 (P<0.01) when the cutting points are Rest SBP(140 mmHg) and FEV₁(80%pred). While the OR of Peak VO₂(80%pred)、Peak SBP(180 mmHg)、Peak VO₂ (20 ml/(min·kg)) and VE/VCO₂Slope(30) are respectively2.66、2.62、2.43 and 2.12 (P<0.05). Conclusion: For patients undergoing thoracoscopic lung resection with good function, the preoperative CPET core indicators can accurately predict the risk of postoperative complications, which is worthy of in-depth study.

Key words: cardiopulmonary exercise testing, rest lung function testing, overall functional status indicator, lung resection, precise prediction, complications after anesthesia surgery

CLC Number:

R619

YU Jian-yun, SUN Xing-guo, LU Lin, BAO Li-fang, JIANG Jun. Cardiopulmonary exercise test accurately prognoses risk of postoperative complications in patients undergoing lung resection in good functional status[J]. CJAP, 2021, 37(2): 195-201.

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