The Clinical Impact of 6-Min Walk Test Distance as a Predictor of Complications in Patients Undergoing Major Surgery

Excerpt

Significantly reduced 6-min walk test (6MWT) distances, in our opinion, reflect limited functional health status of patients undergoing the test. This is an additional tool for patients and surgeons to consider in deciding whether to proceed with major surgical procedures or opt for medical treatment. The poor 6MWT results may also swing physicians to abandon, altogether, open traditional surgeries in favor of newer technologies/procedures. In a study by Bauger et al., 6MWT was performed on patients with severe aortic stenosis who were considered a very high surgical risk for traditional approach [1]. The mean 6MWT distance walked was 165.3 ± 79.7 m which reflected the health status of those high-risk patients. Similarly on examining our data, we noted that a 6MWT distance of 250 m may be a “cut-off distance” below which the surgical risks and complications are significantly increased. Surgeons should deliberate the findings of reduced 6MWT distances (<250 m) very seriously with their patients before proceeding with surgery. Again, alternative approaches should be considered. In the case of severe aortic stenosis, for example, transcatheter aortic valve implantation should be considered first rather than proceeding with traditional open thoracotomy surgery. …