Prediction of morbidity after lung resection with risk factors using treadmill exercise test.
OBJECTIVE
To predict accurate morbidity after lung resection using treadmill exercise test.


METHODS
A total of 130 patients (108 men and 22 women, with mean age 67.1+/-11.4 years (range, 34-78 years)) of 1129 patients underwent standard lobectomy were performed both treadmill exercise test and spirometry preoperatively. We measured maximum oxygen uptake/body weight (VO2max/BW) and change in arterial blood oxygen pressure from rest to symptom-limited maximum loading (delta aPaO2) and calculated exercise-induced hypoxemia (delta PaO2/delta VO2/BW), and retrospectively compared these parameters for patients with and without complications.


RESULTS
There were five patients with severe postoperative complications, including three requiring use of a respirator, two with home oxygen therapy. %Vital capacity, VC (%, 80.2+/-13.2 vs. 92.5+/-20.9, P=0.026), delta PaO2 (Torr, -29.3+/-4.3 vs. -13.2+/-10.8, P=0.0004), VO2max/BW (ml/min/kg, 16.5+/-2.9 vs. 20.6+/-5.1, P=0.018) and delta PaO2/delta VO2/BW (Torr/ml/min/kg, -1.98+/-0.26 vs. -0.57+/-0.47) were significantly associated with worse outcome. All the five patients with complications had delta PaO2/delta VO2/BW<-1.7.


CONCLUSIONS
Treadmill exercise testing is a good method for assessment of cardiopulmonary reserve. Limited resection must be performed if delta PaO2/delta VO2/BW is under -1.7.
Department of Surgery, Hyogo Prefectural Kaibara Hospital, Kaibara, Hyogo, Japan. hmatsuoka1@mac.com
Hidehito
H
Matsuoka
Wataru
W
Nishio
Toshihiko
T
Sakamoto
Hiroaki
H
Harada
Noriaki
N
Tsubota
D000328:Adult; D000368:Aged; D005080:Exercise Test; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology / Q000601:surgery*; D008171:Lung Diseases / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D013147:Spirometry; D013908:Thoracotomy
D010100:Oxygen