European Surgery

, Volume 47, Issue 6, pp 324–330

Cardiopulmonary exercise testing versus spirometry as predictors of cardiopulmonary complications after colorectal surgery

  • I. Nikolopoulos
  • M. Ellwood
  • M. George
  • E. Carapeti
  • A. Williams
Original Article

DOI: 10.1007/s10353-015-0359-z

Cite this article as:
Nikolopoulos, I., Ellwood, M., George, M. et al. Eur Surg (2015) 47: 324. doi:10.1007/s10353-015-0359-z
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Summary

Background

To determine the predictive value of spirometry and cardiopulmonary exercise testing (CPET) preoperatively in patients scheduled to undergo elective colorectal surgery. We compared the preoperative results with the incidence of postoperative cardiopulmonary complications.

Methods

A total of 103 patients were scheduled to undergo preoperative CPET and spirometry; 14 patients did not attend their appointments and another 20 were unable to perform the test. In all, 69 patients (median age 60 years (range 25–85), 35 males) successfully completed cycle ergometry and lung function tests. Forced expiratory volume in 1 s (FEV1), percent forced expiratory volume in 1 s (FEV1/forced vital capacity (FVC)) and anaerobic threshold (AT) were measured. Patients were divided postoperatively according to whether cardiopulmonary complications were absent (group A) or present (group B).

Results

Postoperative cardiopulmonary complications developed in 8 of the 69 patients (12 %). Thirty day mortality was 3 %. AT was significantly higher in group A (mean AT = 13.8; SD ± 3.0; range = 8.1–20.8) than in group B (mean = 10.91; SD ± 3.0; Range = 7.9–12), (p = 0.0006). Spirometric pulmonary function tests (FEV1, p = 0.09) and (FEV1/FVC, p = 0.08) showed no intergroup differences. The median hospital length of stay (HLOS) was significantly higher in the group of patients that suffered cardiopulmonary complications (p = 0.0282).

Conclusions

CPET allows the prediction of postoperative cardiopulmonary complications which cannot be anticipated by spirometry. Early detection of high risk patients facilitates the planning of patient specific management strategies which are likely to improve outcome through invasive monitoring and optimisation of cardio-respiratory function.

Keywords

Cardiopulmonary exercise testing Spirometry Enhance recovery programme Cardiopulmonary complications 

Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  • I. Nikolopoulos
    • 1
  • M. Ellwood
    • 2
  • M. George
    • 2
  • E. Carapeti
    • 3
  • A. Williams
    • 2
  1. 1.Department of General SurgeryLewisham and Greenwich NHS TrustLondonUK
  2. 2.Department of General SurgeryGuy’s and St Thomas’ Foundation NHS TrustLondonUK
  3. 3.London Bridge HospitalLondonUK

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