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Eur J Cardiothorac Surg 2004;26:480-482
© 2004 Elsevier Science NL

Prediction of morbidity after lung resection with risk factors using treadmill exercise test

^a Department of Surgery, Hyogo Prefectural Kaibara Hospital, Kaibara, Hyogo, Japan
^b Department of Thoracic Surgery, Hyogo Medical Center for Adults, Kitaoji-cho 13-70, Akashi City, 673-8558 Hyogo, Japan

Received 16 February 2004; received in revised form 4 May 2004; accepted 10 May 2004.

^* Corresponding author. Tel.: +81-79572-0524; fax: +81-79572-1276
e-mail: hmatsuoka1{at}mac.com

Objective: To predict accurate morbidity after lung resection using treadmill exercise test. Methods: A total of 130 patients (108 men and 22 women, with mean age 67.1±11.4 years (range, 34–78 years)) of 1129 patients underwent standard lobectomy were performed both treadmill exercise test and spirometry preoperatively. We measured maximum oxygen uptake/body weight (VO₂max/BW) and change in arterial blood oxygen pressure from rest to symptom-limited maximum loading (delta aPaO₂) and calculated exercise-induced hypoxemia (delta PaO₂/delta VO₂/BW), and retrospectively compared these parameters for patients with and without complications. Results: There were five patients with severe postoperative complications, including three requiring use of a respirator, two with home oxygen therapy. %Vital capacity, VC (%, 80.2±13.2 vs. 92.5±20.9, P=0.026), delta PaO₂ (Torr, –29.3±4.3 vs. –13.2±10.8, P=0.0004), VO₂max/BW (ml/min/kg, 16.5±2.9 vs. 20.6±5.1, P=0.018) and delta PaO₂/delta VO₂/BW (Torr/ml/min/kg, –1.98±0.26 vs. –0.57±0.47) were significantly associated with worse outcome. All the five patients with complications had delta PaO₂/delta VO₂/BW<–1.7. Conclusions: Treadmill exercise testing is a good method for assessment of cardiopulmonary reserve. Limited resection must be performed if delta PaO₂/delta VO₂/BW is under –1.7.

Key Words: Morbidity • Treadmill exercise test • Operative risk • Lung resection

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