PURPOSE: Patients undergoing thoracic surgery may develop postoperative complications (POC) and some variables are proposed as risk predictors. The purpose of this study was to determine whether 6MWT distance and stair-climbing test time (SCTt) can predict post-thoracotomy complications.
METHODS: Ninety-eight patients undergoing thoracotomy for noncardiac surgery were included. Before surgery, anamnesis, physical and laboratory tests, electrocardiography, spirometry, 6MWT and SCTt were performed in all patients. The risk indexes of Charlson, Goldman, ASA, Torrington and Henderson, and Destky were determined. All complications observed between the immediate postoperative period and hospital discharge were recorded. Patients were allocated into two groups according to absence (A) or presence (B) of complications. Student’s t test for independent populations was used to compare 6MWT distances and SCTt. Associations between variables and complications were tested by logistic regression.
RESULTS: Of all patients evaluated, 27 (27.6%) had POC. Age was significantly higher in group B (A=50.5±17.4, B=58.4±15.3, p=0.04). No significant difference in FEV1 was observed (A=2.4±0.8, B=2.1±0.6, p=0.08). Complication rate significantly increased as Charlson, Goldman and Detsky scores rose, but no significance was observed with regard to Torrington and Henderson and ASA scores. The 6MWT distance covered by the patients with POC (527.0±99.2m) was significantly shorter than that walked by those who experienced no complications (586.5±85.4m) (p=0.004). SCTt was significantly higher in the group with complications (46.6±17.4s) compared to the group without complications (35.8±12.8s) (p=0.005). The cutoff point for the SCTt obtained using a ROC curve was 37.5s. Multivariate analysis revealed that SCt was the only significant variable associated with the presence of complications. The chance of experiencing complications was 9.37-fold higher if SCTt≥50s, as compared to SCTt< 30s.
CONCLUSION: 6MWT distance and SCTt allowed differentiating groups with and without complications, but SCTt was the only variable that associated with complications according to multivariate analysis.
CLINICAL IMPLICATIONS: These tests allow cheap identifying patients who are likely to have complications and makes it’s possible to make further investigations before surgery.
DISCLOSURE: Daniele Cataneo, No Financial Disclosure Information; No Product/Research Disclosure Information