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

Anaesthesia. 2015 Jun;70(6):679-85. doi: 10.1111/anae.12986. Epub 2015 Feb 6.

Abstract

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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anaerobic Threshold
  • Aortic Aneurysm, Abdominal / surgery*
  • Carbon Dioxide / metabolism
  • Critical Care
  • Exercise Test / methods*
  • Exercise Test / statistics & numerical data
  • Female
  • Heart Diseases / etiology
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Physical Fitness
  • Postoperative Care
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / mortality
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Assessment
  • Vascular Surgical Procedures

Substances

  • Carbon Dioxide