title: Cardiopulmonary exercise testing provides a predictive tool for early and late outcomes in abdominal aortic aneurysm patients.
abstract: BACKGROUND
  The aim of this study was to determine if cardiopulmonary exercise testing (CPET) predicts 30-day and mid-term outcomes when assessing suitability for abdominal aortic aneurysm (AAA) repair.
  
  
  METHODS
  Since July 2006 consecutive patients from a single centre identified with a large (≥5.5 cm) AAA were sent for CPET. Follow-up was completed on 1 August 2009. Univariate logistical regression was used to compare CPET parameters with the Detsky score, the Acute Physiology and Chronic Health Evaluation (APACHE) II score and the Vascular Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (VPOSSUM) in predicting predefined early and late outcome measures.
  
  
  RESULTS
  Full data were available for 102 patients (93% male, median age: 75 years, interquartile range (IQR): 70-80 years, median follow up: 28 months, IQR: 18-33 months). Ventilatory equivalents for oxygen and APACHE II predicted postoperative inotrope requirement (p=0.018 and p=0.019 respectively). The Detsky score predicted the length of stay in the intensive care unit (p=0.008). Mid-term (30-month) survival was predicted by the anaerobic threshold (p=0.02).
  
  
  CONCLUSIONS
  CPET provided the only means in this study of predicting both 30-day outcome and 30-month mortality. CPET could therefore become an increasingly important tool in determining the optimum management for AAA patients.
authors.affiliation: Vascular Surgery Department, Royal Berkshire Hospital, Reading, UK.
authors.forename: A R
authors.initials: AR
authors.lastname: Thompson
authors.forename: N
authors.initials: N
authors.lastname: Peters
authors.forename: R E
authors.initials: RE
authors.lastname: Lovegrove
authors.forename: S
authors.initials: S
authors.lastname: Ledwidge
authors.forename: A
authors.initials: A
authors.lastname: Kitching
authors.forename: T R
authors.initials: TR
authors.lastname: Magee
authors.forename: R B
authors.initials: RB
authors.lastname: Galland
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D057510:Endovascular Procedures / Q000401:mortality*; D005080:Exercise Test / Q000401:mortality*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000401:mortality*; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents