Association between recovery from desaturation after stair climbing and postoperative complications in lung resection

The stair-climbing test (SCT) is used as a surrogate for cardiopulmonary exercise testing, which measures maximal oxygen uptake, and considered a useful method for assessing exercise capacity in thoracic surgery. This study aims to investigate whether the recovery time of percutaneous oxygen saturation (SpO₂) after stair climbing is a predictor of postoperative complications after lobectomy.

We retrospectively identified 54 patients who performed SCT and underwent lobectomy between January 2015 and February 2023 at Shizuoka Cancer Center. The SpO₂ recovery time was defined as the time required to recover from the minimum to resting value after stair climbing. The association between SpO₂ recovery time and early postoperative pulmonary complications within 30 days after surgery was analyzed.

Eleven patients (20.4%) had postoperative pulmonary complications (≥ Clavien-Dindo Classification Grade 2). The cutoff value of SpO₂ recovery time obtained from the receiver operating characteristic curve analysis was 90 s [sensitivity, 81.8%; specificity, 72.1%; AUC, 0.77 (95% confidence interval, 0.64-0.90)]. The occurrence of postoperative pulmonary complications was 42.9% in the delayed recovery time (DRT; SpO₂ recovery time ≥ 90 s) group and 6.1% in the non-DRT (SpO₂ recovery time < 90 s) group (p = 0.002). DRT was a predictor of postoperative pulmonary complications (odds ratio, 11.60; 95% CI 2.19-61.80).

DRT of SpO₂ after stair climbing is a predictor of postoperative pulmonary complications following lobectomy in borderline patients who require exercise capacity assessment. SpO₂ monitoring after stair climbing may be useful as one of the preoperative assessments in patients undergoing lobectomy.