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General Thoracic and Cardiovascular Surgery

Published in:

01-10-2014 | Original Article

Clinical relevance of decreased oxygen saturation during 6-min walk test in preoperative physiologic assessment for lung cancer surgery

Authors: Tatsuo Nakagawa, Naohisa Chiba, Masao Saito, Yasuto Sakaguchi, Shinya Ishikawa

Published in: General Thoracic and Cardiovascular Surgery | Issue 10/2014

Abstract

Objective

The Japanese Association for Chest Surgery (JACS) has released guidelines on preoperative physiologic assessment for lung cancer surgery. However, cardiopulmonary exercise testing (CPET), which is recommended for patients with poor pulmonary function, is available only in limited institutions. We investigated the possibility of 6-min walk test (6MWT) as a substitute of maximum oxygen consumption test (VO₂max) on preoperative physiologic assessment for lung cancer surgery.

Methods

The relationship between VO₂max and 6MWT was retrospectively analyzed in 51 subjects other than lung cancer patients. Following the preliminary analysis, we modified the risk assessment in the JACS guidelines by substituting 6MWT for VO₂max, and patients who underwent lung cancer surgery were retrospectively assessed using the modified assessment.

Results

Analysis of the correlation between VO₂max and 6MWT revealed VO₂max to be significantly correlated to minimum SpO₂ (SpO₂min) and maximum decrease in SpO₂ (ΔSpO₂) during 6MWT. Receiver operating characteristic analysis revealed that SpO₂min and ΔSpO₂ were predictable for a VO₂max of 15 mL/kg/min, which is the borderline between the average- and increased-risk groups in the JACS guidelines. A total of 1,066 patients were assigned to the average- or increased-risk group according to the modified JACS guidelines using the criteria of SpO₂min < 91 % and ΔSpO₂ > 4 %. The increased-risk group was significantly inferior to the average-risk group in Home Oxygen Therapy induction rate, cardiopulmonary-related 30- and 90-day mortality (p < 0.001).

Conclusions

In clinical practice, decreased saturation during 6MWT may be simple and substitutive for CPET in risk assessment for lung cancer surgery using the JACS guidelines.

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Title: Clinical relevance of decreased oxygen saturation during 6-min walk test in preoperative physiologic assessment for lung cancer surgery
Authors: Tatsuo Nakagawa
Naohisa Chiba
Masao Saito
Yasuto Sakaguchi
Shinya Ishikawa
Publication date: 01-10-2014
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 10/2014
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-014-0413-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical relevance of decreased oxygen saturation during 6-min walk test in preoperative physiologic assessment for lung cancer surgery

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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