ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

 Click here to read this article as a CME activity

Ann Thorac Surg 2008;86:240-248. doi:10.1016/j.athoracsur.2008.03.025
© 2008 The Society of Thoracic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Alessandro Brunelli
Majed Refai
Michele Salati
Right arrow Permission Requests
Google Scholar
Right arrow Articles by Brunelli, A.
Right arrow Articles by Sabbatini, A.
PubMed
Right arrow Articles by Brunelli, A.
Right arrow Articles by Sabbatini, A.
Related Collections
Right arrow Lung - cancer

Original Articles: General Thoracic

Performance at Symptom-Limited Stair-Climbing Test is Associated With Increased Cardiopulmonary Complications, Mortality, and Costs After Major Lung Resection

Alessandro Brunelli, MD*, Majed Refai, MD, Francesco Xiumé, MD, Michele Salati, MD, Valeria Sciarra, MD, Laura Socci, MD, Armando Sabbatini, MD

Unit of Thoracic Surgery, Umberto I Regional Hospital, Ancona, Italy

Accepted for publication March 14, 2008.

* Address correspondence to Dr Brunelli, Via S Margherita 23, Ancona, 60129, Italy (Email: alexit_2000{at}yahoo.com).

Presented at the Forty-fourth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 27–29, 2008.

Background: Exercise tests are increasingly used during preoperative evaluation before lung resection. This study assessed the association between performance at the symptom-limited stair-climbing test and postoperative cardiopulmonary morbidity, mortality, and costs after major lung resections.

Methods: As part of their routine preoperative evaluation, 640 patients who had lobectomy (n = 533) or pneumonectomy (n = 107) for lung cancer from January 2000 through April 2007 performed a preoperative symptom-limited stair-climbing test. Sensitivity/specificity analysis was used to identify the best cutoff values of altitude climbed (number of steps x height of the step in m) associated with outcome. Univariate and multivariate regression analyses (validated by bootstrap) were used to test associations between preoperative and operative factors and postoperative cardiopulmonary complications, mortality, and postoperative costs.

Results: The altitude reached at the stair-climbing test was reliably associated with increased cardiopulmonary complications (p = 0.04), mortality (p = 0.02), and costs (p < 0.0001). In patients who climbed less than 12 m, cardiopulmonary complications, mortality, and costs were 2-fold (p < 0.0001), 13-fold (p < 0.0001), and 2.5-fold higher, respectively, than in patients who climbed more than 22 m.

Conclusions: Performance at a maximal stair-climbing test was reliably associated with postoperative morbidity and mortality. We recommend the use of this simple and economic test in all lung resection candidates. Patients who perform poorly at the stair-climbing test should undergo a formal cardiopulmonary exercise test with measurement of oxygen consumption to optimize their perioperative management.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2008 by The Society of Thoracic Surgeons.