الفهرس 
Perioperative Assessment in Thoracic Surgery CandidatesOnly 14 pages are availabe for public view
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Abstract
Purpose: Patients undergoing thoracic surgery may develop postoperative complications and some variables are proposed as risk predictors. The purpose of this study was to determine whether cardiopulmonary exercise testing (CPET) can predict post-thoracotomy complications. Design: The study was designed as a prospective study. Patients and Methods: Thirty patients undergoing thoracotomy for non-cardiac surgery at Ain Shams University and Abbassia Chest Hospital over one year were included. Preoperative symptom- limited cardiopulmonary exercise testing (CPET), spirometry, 6MWT and cardiopulmonary risk index were performed to all patients. We also recorded the outcome of surgery, in particular, complications and mortality. Patients were allocated into three groups according to absence (A) or presence (B) of complications and death (c). Results: VO2max ≤ 16.2 ml/kg/min had 94% diagnostic accuracy with 100% sensitivity and 81% specificity. BR ≤ 4.9 L/min had 90% diagnostic accuracy with 100% specificity and 75% sensitivity. AT ≤ 10.9 ml/kg/min had 90% diagnostic accuracy with 87.50% sensitivity and 81.82% specificity. CPRI score of 4 or more had 98% diagnostic accuracy with 100% sensitivity and 86% specificity. Six minute walk distance (6MWD) ≤ 308m had 83% diagnostic accuracy with 95% specificity and 62% sensitivity. MVV ≤ 65 L/min and FEV1 ≤ 1.8 L had the highest diagnostic accuracy (89%, 88%) respectively, with the same sensitivity 87% and specificity 81%. Prolonged air leak and respiratory failure were the reported postoperative complication. Conclusion: The CPET was a good predictor of postoperative complications following thoracic surgery. We have demonstrated that significantly reduced Vo2 max (ml/kg/min), BR (l/min) and AT (ml/kg/min) indicated an increased postoperative risk.