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Association between values of preoperative 6-min walk test and surgical outcomes in lung cancer patients with decreased predicted postoperative pulmonary function

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Abstract

Objective

We retrospectively investigated the possibility that the 6-min walk test (6MWT) could predict surgical outcomes in lung cancer patients with decreased predicted postoperative (ppo) lung function.

Methods

Patients were enrolled based on their preoperative spirometry: <60% of the ppo forced expiratory volume in 1 s (FEV1.0) or < 60% of the ppo lung carbon monoxide diffusion capacity (DLco). Morbidity, oxygen inhalation required > 10 days, home oxygen therapy (HOT) requirement, unexpected readmission within 90 days, and 90-day mortality were included as surgical outcomes. The correlations with walking distance and the minimum SpO2 (SpO2min) and maximum decrease in SpO2 (ΔSpO2) during the 6MWT were analyzed using logistic regression analysis, adjusting for age, sex, and surgical procedure.

Results

Altogether, 121 patients were analyzed. Logistic regression analysis revealed that higher ΔSpO2 and lower SpO2min were significantly correlated with a higher risk of prolonged need for oxygen inhalation and HOT, surgical morbidity, and 90-day mortality. Cut-off values of > 4% for ΔSpO2 were significant for prolonged oxygen inhalation and surgical morbidity. Cut-off values of < 89–91% for SpO2min were also significant for the need for prolonged oxygen inhalation, surgical morbidity, and HOT requirement. There were no significant correlations between walking distance and each surgical outcome.

Conclusions

Oxygen desaturation during 6MWT was a good predictor for poor surgical outcomes in lung cancer patients with decreased ppo pulmonary function.

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Abbreviations

6MWT:

6-min walk test

CPET:

Cardiopulmonary exercise test

DLCO :

Carbon monoxide diffusion capacity of the lung

FEV1.0 :

Forced expiratory volume in 1 s

ppo:

Predicted postoperative

SpO2 :

Oxygen saturation

\(\dot {V}\)O2max:

Maximum oxygen consumption

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Acknowledgements

We thank Nancy Schatken, BS, MT(ASCP), from Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Tenri Hospital, 200 Mishima, Tenri, Nara, 632-8552, Japan

    Tatsuo Nakagawa, Yasuaki Tomioka, Toshiya Toyazaki & Masashi Gotoh

Authors
  1. Tatsuo Nakagawa
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  2. Yasuaki Tomioka
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  3. Toshiya Toyazaki
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  4. Masashi Gotoh
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Corresponding author

Correspondence to Tatsuo Nakagawa.

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The authors have declared that no conflict of interest exists.

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Supplementary Fig. 1

Correlation analysis of each 6-min walk test (6MWT) covariate with surgical outcomes in the major anatomical resection group. SpO 2 min minimum oxygen saturation, ΔSpO 2 change in SpO2, Distance distance walked in 6 min. Bold squares (■) = hazard ratios that were statistically significant; open squares (□) = hazard ratios that were not statistically significant (PPTX 711 KB)

Supplementary Fig. 2

Analysis of the change in oxygen saturation (ΔSpO2) and the minimum oxygen saturation (SpO2min) divided with cut-off values compared with surgical outcomes in the major anatomical resection group. Bold squares (■) = hazard ratios that were statistically significant; open squares = hazard ratios that were not statistically significant (PPTX 1373 KB)

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Nakagawa, T., Tomioka, Y., Toyazaki, T. et al. Association between values of preoperative 6-min walk test and surgical outcomes in lung cancer patients with decreased predicted postoperative pulmonary function. Gen Thorac Cardiovasc Surg 66, 220–224 (2018). https://doi.org/10.1007/s11748-018-0888-z

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  • DOI: https://doi.org/10.1007/s11748-018-0888-z

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