| Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients. | |
| | |
MedLine Citation:
|
PMID: 18293457 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
AIM: To test the predictive value of stairs climbing test for the development of postoperative complications in lung cancer patients with forced expiratory volume in one second (FEV1)<2 L, selected for an elective lung surgery. METHODS: The prospective study was conducted in 101 consecutive patients with an FEV1<2 L selected for elective lung surgery for lung cancer. Preoperative examination included medical history and physical examination, lung function testing, electrocardiography, laboratory testing, and chest radiography. All patients underwent stairs climbing with pulse oximetry before the operation with the number of steps climbed and the time to complete the test recorded. Oxygen saturation and pulse rate were measured every 20 steps. Data on postoperative complications including oxygen use, prolonged mechanical ventilation, and early postoperative mortality were collected. RESULTS: Eighty-seven of 101 patients (86%) had at least one postoperative complication. The type of surgery was significantly associated with postoperative complications (25.5% patients with lobectomy had no early postoperative complications), while age, gender, smoking status, postoperative oxygenation, and artificial ventilation were not. There were more postoperative complications in more extensive and serious types of surgery (P<0.001). The stairs climbing test produced a significant decrease in oxygen saturation (-1%) and increase in pulse rate (by 10/min) for every 20 steps climbed. The stairs climbing test was predictive for postoperative complications only in lobectomy group, with the best predictive parameter being the quotient of oxygen saturation after 40 steps and test duration (positive likelihood ratio [LR], 2.4; 95% confidence interval [CI], 1.71-3.38; negative LR, 0.53; 95% CI, 0.38-0.76). In patients with other types of surgery the only significant predictive parameter for incident severe postoperative complications was the number of days on artificial ventilation (P=0.006). CONCLUSION: Stairs climbing test should be done in routine clinical practice as a standard test for risk assessment and prediction of the development of postoperative complications in lung cancer patients selected for elective surgery (lobectomy). Comparative to spirometry, it detects serious disorders in oxygen transport that are a baseline for a later development of cardiopulmonary postoperative complications and mortality in this subgroup of patients. |
| | |
Authors:
|
Igor Nikolić; Visnja Majerić-Kogler; Davor Plavec; Ivana Maloca; Zoran Slobodnjak |
Related Documents
:
|
18046897 - Functional results of unilateral lung volume reduction surgery in alpha1-antitrypsin de... 8751507 - Video-assisted thoracoscopic treatment of spontaneous pneumothorax: technique and resul... 17210397 - A randomized trial of t3-t4 versus t4 sympathectomy for isolated axillary hyperhidrosis. 12496327 - Thoracoscopic sympathectomy for palmar hyperhidrosis and raynaud's phenomenon of the up... 9489907 - Prevention of gastric ulcer recurrence with tetraprenylacetone. 21351807 - Multisystem langerhans cell histiocytosis in children: current treatment and future dir... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Croatian medical journal Volume: 49 ISSN: 1332-8166 ISO Abbreviation: Croat. Med. J. Publication Date: 2008 Feb |
Date Detail:
|
Created Date: 2008-02-22 Completed Date: 2008-03-19 Revised Date: 2009-11-18 |
Medline Journal Info:
|
Nlm Unique ID: 9424324 Medline TA: Croat Med J Country: Croatia |
Other Details:
|
Languages: eng Pagination: 50-7 Citation Subset: IM |
Affiliation:
|
Department for Thoracic Surgery, Jordanovac University Hospital for Lung Diseases, Zagreb, Croatia. inik11@net.hr |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Aged, 80 and over Exercise Test Female Forced Expiratory Volume Health Status Indicators Heart Rate Humans Lung / surgery* Lung Neoplasms / mortality, surgery* Male Middle Aged Oximetry* Postoperative Complications / mortality* Prospective Studies Respiration, Artificial Risk Factors Spirometry Surgical Procedures, Elective / adverse effects, mortality* Thoracic Surgery* Time Factors |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Association of methylenetetrahydrofolate reductase (MTHFR-677 and MTHFR-1298) genetic polymorphisms ...
Next Document: Surgical site infections in orthopedic patients: prospective cohort study.