Performance in the shuttle walk test is associated with cardiopulmonary complications after lung resections

被引:23
作者
Fennelly, Joseph [1 ]
Potter, Lauren [1 ]
Pompili, Cecilia [2 ]
Brunelli, Alessandro [1 ]
机构
[1] St James Univ Hosp, Dept Thorac Surg, Beckett St, Leeds LS9 7TF, W Yorkshire, England
[2] Leeds Inst Canc & Pathol, Sect Patient Ctr Outcomes Res, Leeds, W Yorkshire, England
关键词
Shuttle walk test (SWT); exercise test; lung surgery; lung cancer; complications; OXYGEN-CONSUMPTION; CANCER; SURGERY; GUIDELINES;
D O I
10.21037/jtd.2017.03.22
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: The current functional guidelines recommend the shuttle walk test (SWT) as an initial screening tool to identify candidates for lung resection without requiring cardiopulmonary exercise testing. This study aims to: (I) assess the use of the SWT in predicting postoperative cardiopulmonary complications; and (II) determine whether the recommended 400 m cut-off is an appropriate distance. Methods: We retrospectively analysed 101 patients that had performed a SWT prior to surgery. Univariate and multivariate regression analyses were used to test associations between patient variables [demographics, pre-existing conditions, pulmonary function, oxygen desaturation during the SWT, shuttle walk distance (SWD)] and post-operative cardiopulmonary complications. Results: Patients without cardiopulmonary complications walked longer distance compared to those with complication (417.3 vs. 348.6 m, P=0.01. Fifty two patients walked less than 400 m and 16 less than 250 m. Only 10% of patients who walked at least 400 m had cardiopulmonary complications compared to 33% of those who did not reach this distance (P=0.008). Half of the patients who walked less than 400 m and desaturated during the exercise developed cardiopulmonary complications. A SWD shorter than 400 m remained the only factor significantly associated with cardiopulmonary complications (P=0.009, OR: 4.3) after logistic regression analysis. Conclusions: Our results support the use of the SWT as an initial screening tool in all patients prior to lung resection. Patients walking longer than 400 m experienced very low incidence of complications and would not need further testing prior to proceed to lung resection.
引用
收藏
页码:789 / 795
页数:7
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