Veeralakshmanan P; Department of Vascular Surgery, Birmingham, UK.
Juszczak M; Tiwari A

Vascular & Endovascular Surgery. 58(8):862-865, 2024 Nov.

BACKGROUND: Cardiopulmonary exercise testing (CPET) is a preoperative risk
stratification tool providing an objective measure of fitness and
functional capacity. There is however little evidence on the use of this
compared to non-physiological test in vascular surgery despite its current
use. This study investigates whether CPET perioperatively has value
alongside non-physiological testing for patients undergoing elective open
abdominal aortic aneurysm (AAA) repair.
METHOD: Retrospective data was collected at 2 vascular centres between
2015-2019 in a CPET centre vs non-CPET centre in patients undergoing
elective AAA repair. Outcomes measured included: length of stay in an
intensive care unit (ICU); total length of stay; post-operative
complications and acute kidney injury (AKI). Statistical analysis was
performed using IBM SPSS software.
RESULTS: There were 38 patients at each centre. The mean duration of stay
in ICU for patients in CPET centre was 2.5 +/- 2.13 days whilst in
non-CPET centre it was 3.68 +/- 4.08 days (P = 0.05). The mean duration of
stay in ICU and total length of stay was significantly shorter in CPET
centre (P = 0.05 and P = 0.015 respectively). Mortality in CPET centre was
2.63% and 5.26% in non-CPET centre (not significant). The number of
patients developing AKI post-operatively was 13.61% in CPET vs 28.95% in
non-CPET centre.
CONCLUSION: CPET tested patients have statistically significant lower
length of total and ICU stay compared to non-CPET patients. CPET is
therefore a useful adjunct in selecting patients for open surgery compared
to non-physiological testing. This study provides some evidence on the use
of this routinely but not validated assessment tool in aortic aneurysm
repair.