title: Preoperative shuttle walking testing and outcome after oesophagogastrectomy.
abstract: BACKGROUND
  Objective assessment of cardiorespiratory reserve has been recommended before major surgery to identify patients with impaired oxygen delivery who may be at increased operative risk. Access to formal cardiopulmonary exercise (CPX) testing is limited outside larger centres. Following a previous audit of morbidity and mortality after oesophagectomy, we decided to add a simpler form of exercise test to our preoperative screen and review the outcomes.
  
  
  METHODS
  Fifty-one patients who had surgical resection of an oesophageal cancer in our unit between April 2002 and April 2005 carried out an incremental shuttle walk exercise test before operation. Thirty-day outcome data were collected for each patient.
  
  
  RESULTS
  Overall mortality in the group was 10%. No patient who walked 350 m or more died within 30 days. Five of the eight patients who could not achieve this distance died and two others remained in the critical care unit at 30 days.
  
  
  CONCLUSIONS
  Preoperative shuttle walk testing using a standard protocol appears to be a sensitive indicator of operative risk in this group of patients. The apparent threshold value of 350 m is consistent with previously reported measures of functional capacity obtained using formal CPX testing.
authors.affiliation: Department of Anaesthesia and Critical Care, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
authors.forename: P
authors.initials: P
authors.lastname: Murray
authors.forename: P
authors.initials: P
authors.lastname: Whiting
authors.forename: S P
authors.initials: SP
authors.lastname: Hutchinson
authors.forename: R
authors.initials: R
authors.lastname: Ackroyd
authors.forename: C J
authors.initials: CJ
authors.lastname: Stoddard
authors.forename: C
authors.initials: C
authors.lastname: Billings
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy; D005080:Exercise Test / Q000379:methods*; D005743:Gastrectomy; D006801:Humans; D008875:Middle Aged; D010101:Oxygen Consumption; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016138:Walking