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BJA Advance Access originally published online on October 24, 2007
British Journal of Anaesthesia 2007 99(6):809-811; doi:10.1093/bja/aem305
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Preoperative shuttle walking testing and outcome after oesophagogastrectomy

P. Murray1,*, P. Whiting1, S. P. Hutchinson1, R. Ackroyd2, C. J. Stoddard2 and C. Billings3

1 Department of Anaesthesia and Critical Care
2 Upper Gastrointestinal Surgery
3 Respiratory Physiology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK

* Corresponding author. E-mail: paul.murray{at}sth.nhs.uk

Background: Objective assessment of cardiorespiratory reserve has been recommended before major surgery to identify patients with impaired oxygen delivery who may be at increased operative risk. Access to formal cardiopulmonary exercise (CPX) testing is limited outside larger centres. Following a previous audit of morbidity and mortality after oesophagectomy, we decided to add a simpler form of exercise test to our preoperative screen and review the outcomes.

Methods: Fifty-one patients who had surgical resection of an oesophageal cancer in our unit between April 2002 and April 2005 carried out an incremental shuttle walk exercise test before operation. Thirty-day outcome data were collected for each patient.

Results: Overall mortality in the group was 10%. No patient who walked 350 m or more died within 30 days. Five of the eight patients who could not achieve this distance died and two others remained in the critical care unit at 30 days.

Conclusion: Preoperative shuttle walk testing using a standard protocol appears to be a sensitive indicator of operative risk in this group of patients. The apparent threshold value of 350 m is consistent with previously reported measures of functional capacity obtained using formal CPX testing.

Keywords: assessment, preanaesthetic; metabolism, oxygen consumption; oxygen, uptake


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E-letters:

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Pre-operative CPX testing
Chris M Danbury, et al.
British Journal of Anaesthesia, 10 Jan 2008 [Full text]
Response
PAUL MURRAY
British Journal of Anaesthesia, 12 Feb 2008 [Full text]

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