Can the 1-minute sit-to-stand test predict postoperative complications as well as traditional functional tests?

This study aimed to evaluate the predictive power of the 1-min sit-to-stand test (1STST) for postoperative complications and mortality in patients undergoing thoracic surgery and to compare it with the traditional 6-min walk test (6MWT).

In this prospective, single-center observational study, 92 adult patients scheduled for elective thoracic surgery were included. Preoperative functional capacity was assessed using both the 1STST (number of repetitions) and the 6MWT (distance in meters). Postoperative complications, including pulmonary, cardiovascular, and surgical site complications, were recorded. Statistical analyses, including logistic regression and ROC curve analysis, were performed to identify independent predictors of complications.

Postoperative complications occurred in 27.2% (n = 25) of patients. In multivariable logistic regression analysis, elevated preoperative CRP was identified as an independent predictor of postoperative complications (OR = 1.029, 95% CI: 1.001-1.058). Longer hospital stay (OR = 1.698, 95% CI: 1.233-2.339), prolonged ICU stay (OR = 9.310, 95% CI: 1.481-58.525), and surgical approach (thoracotomy vs. VATS; OR = 13.311, 95% CI: 1.242-142.659) were also significantly associated with complications. In analyses limited to postoperative pulmonary complications, neither the 1STS the 6MWT was predictive, whereas preoperative CRP (OR = 0.041, 95% CI: 0.927-0.994), and length of hospital stay (OR = 0.743, 95% CI: 1.315-3.358), were independently associated with adverse outcomes. ROC curve analyses using inverted test scores showed modest and comparable discrimination for the 1STS (AUC = 0.611, 95% CI: 0.476-0.747) and the 6MWT (AUC = 0.620, 95% CI: 0.488-0.752), with no clear superiority of either test. Notably, the post-STS Borg dyspnea score demonstrated moderate discriminatory ability for predicting postoperative complications (AUC = 0.635).

Our findings suggest that neither test alone is sufficient for risk stratification without integration of clinical and biomarker data. Preoperative CRP level, surgical approach, length of intensive care unit stay, and length of hospital stay were the only variables independently associated with adverse outcomes, highlighting the contribution of systemic inflammation and overall clinical burden to perioperative risk assessment.