Use of the pre-operative shuttle walk test to predict morbidity and mortality after elective major colorectal surgery

Anaesthesia
C L Nutt, J C Russell

Abstract

High-risk surgery is performed in every acute hospital. These patients often have increased peri-operative risk related to their poor cardiorespiratory reserve. Formal risk assessment is recommended for such patients; cardiopulmonary exercise testing is a well established triage tool, but is unavailable in many hospitals. We investigated whether a simple exercise test could predict postoperative outcome using a prospective trial of 121 patients undergoing elective major abdominal surgery. Each patient completed a shuttle walk test and was followed up for 30 days after surgery. There was one postoperative death (0.8%), with 53 patients (44%) developing complications. The mean (SD) shuttle walk test distance was significantly different between patients who suffered complications and those who did not (276.6 (134.5) vs 389.6 (138.9) m, respectively; p < 0.001). A cut-off distance of 250 m had a specificity of 0.88 and a sensitivity of 0.58 to predict postoperative complications. Patients unable to complete a shuttle walk test above this cut-off distance were three times more likely to have a postoperative morbidity. We conclude that the shuttle walk test can help identify patients who are at increased peri-operative risk.

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Citations

Dec 16, 2013·Anaesthesia·R E Hubbard, D A Story
Dec 9, 2017·Diseases of the Colon and Rectum·Vladimir BolshinskyAlexander Heriot
Dec 2, 2020·The International Journal of Cardiovascular Imaging·Sherna F AdenwallaMatthew P M Graham-Brown
Oct 31, 2020·International Anesthesiology Clinics·Daniel S Rubin
Jun 4, 2020·European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes·David MartinMartin Hübner

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