Cardiopulmonary exercise testing for predicting postoperative morbidity in patients undergoing hepatic resection...

Area of Science:

• Cardiology
• Surgery
• Pulmonology

Background:

• Cardiopulmonary exercise testing (CPET) is a valuable tool for assessing patient risk.
• Predicting postoperative morbidity is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To determine if CPET variables predict morbidity after major abdominal surgery.
• To identify specific CPET parameters associated with adverse outcomes.

Main Methods:

• 104 high-risk patients undergoing elective open hepatic resection were assessed preoperatively using CPET.
• Postoperative morbidity was evaluated using the Postoperative Morbidity Survey (POMS) on postoperative day 3.

Main Results:

• 70.2% of patients experienced postoperative morbidity.
• Oxygen consumption at anaerobic threshold (V˙O2 at AT) was the sole CPET predictor of morbidity (AUC=0.66).
• In major hepatic resections, V˙O2 at AT <10.2 ml/kg/min showed higher predictive accuracy (AUC=0.79).

Conclusions:

• A V˙O2 at AT cut-off of <10.2 ml/kg/min may aid in identifying patients at risk for morbidity after major hepatic resection.
• CPET is a promising method for preoperative risk stratification in surgical patients.