Prediction of organ-specific complications following abdominal aortic aneurysm repair using cardiopulmonary exercise testing.

Barakat HM; Shahin Y; McCollum PT; Chetter IC,

ISSN: 1365-2044, 2015 Jun; Vol. 70 (6), pp. 679-85;
Publisher: Wiley-Blackwell; PMID: 25656939;

This study aimed at
assessing whether measures of aerobic fitness can predict postoperative
cardiac and pulmonary complications, 30-day mortality and length of
hospital stay following elective abdominal aortic aneurysm repair. We
prospectively collected cardiopulmonary exercise testing data over two
years for 130 patients. Upon multivariate analysis, a decreased
anaerobic threshold (OR (95% CI) 0.55 (0.37-0.84); p = 0.005) and open
repair (OR (95% CI) 6.99 (1.56-31.48); p = 0.011) were associated with
cardiac complications. Similarly, an increased ventilatory equivalent
for carbon dioxide (OR (95% CI) 1.18 (1.05-1.33); p = 0.005) and open
repair (OR (95% CI) 14.29 (3.24-62.90); p < 0.001) were associated with
pulmonary complications. Patients who had an endovascular repair had
shorter hospital and critical care lengths of stay (p < 0.001).
Measures of fitness were not associated with 30-day mortality or length
of hospital stay. Cardiopulmonary exercise testing variables,
therefore, seem to predict different postoperative complications
following abdominal aortic aneurysm repair, which adds value to their
routine use in risk stratification and optimisation of peri-operative
care.© 2015 The Association of Anaesthetists of Great Britain and