Next Article in Journal
Combined Effects of Race and Socioeconomic Status on Cancer Beliefs, Cognitions, and Emotions
Next Article in Special Issue
The Role of Manual Therapy in Patients with COPD
Previous Article in Journal
The Quality of Life among Men Receiving Active Surveillance for Prostate Cancer: An Integrative Review
Previous Article in Special Issue
Systematic Review of Pain in Clinical Practice Guidelines for Management of COPD: A Case for Including Chronic Pain?
Article Menu
Issue 1 (March) cover image

Export Article

Open AccessArticle

Desaturation during Six-Minute Walk Testing Predicts Major Morbidity Following Anatomic Lung Resection among Patients with COPD

1
Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA
2
Division of Trauma, Critical Care, Burns, and Emergency General Surgery, MetroHealth Medical Center, Case Western Reserve School of Medicine, Cleveland, OH 44109, USA
*
Author to whom correspondence should be addressed.
Healthcare 2019, 7(1), 16; https://doi.org/10.3390/healthcare7010016
Received: 19 October 2018 / Revised: 8 January 2019 / Accepted: 11 January 2019 / Published: 23 January 2019
(This article belongs to the Special Issue Chronic Obstructive Pulmonary Disease: Updates in Lung Health)
  |  
PDF [429 KB, uploaded 18 February 2019]
  |  

Abstract

Background: Pulmonary function testing (PFT) is commonly used to risk-stratify patients prior to lung resection. Guidelines recommend that patients with reduced lung function, due to chronic lung conditions such as Chronic Obstructive Pulmonary Disease (COPD), should receive additional physiologic testing to determine fitness for resection. We reviewed our experience with six-minute walk testing (SMWT) to determine the association of test results and post-operative complications. Methods: Consecutive adult patients undergoing segmentectomy, lobectomy, bilobectomy or pneumonectomy between 1 January, 2007 and 1 January, 2017 were identified in a prospectively maintained database. Patients with poor lung function, as defined by percent predicted forced expiratory volume in 1 s (FEV1) or diffusion capacity of carbon monoxide (DLCO) ≤60%, had results of SMWT extracted from their chart. Association of test result to post-operative events was performed. Results: 581 patients had anatomic lung resections with predicted post-operative FEV1 or DLCO values ≤60%, consistent with a diagnosis of COPD. Among them, 50 (8.6%) had preoperative SMWT performed. Patients who received SMWT were more likely to have a FEV1 or DLCO less than 40 percent predicted (24/50 (48.0%) vs 166/531 (31.3%), p = 0.016). Post-operatively, patients who had SMWT performed had higher rates of pneumonia, but similar rates of major morbidity. The post-exercise oxygen saturation and the amount of desaturation correlated with the occurrence of major morbidity. In multivariable regression, oxygen desaturation was an independent risk factor for the occurrence of major morbidity, and desaturation was an excellent predictor of major morbidity by receiver operating characteristic curves analsysis. Conclusions: Among patients with elevated risk, oxygen desaturation during SMWT was independently associated with the occurence of major morbidity in multivariable analysis, while pulmonary function testing was not. SMWT is an important tool for risk-stratification, and may be underutilized. View Full-Text
Keywords: thoracic surgery; pulmonary function testing; six-minute walk; surgery; risk-stratification thoracic surgery; pulmonary function testing; six-minute walk; surgery; risk-stratification
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Towe, C.W.; Wu, K.; Khil, A.; Perry, Y.; Worrell, S.G.; Ho, V.P.; Linden, P.A. Desaturation during Six-Minute Walk Testing Predicts Major Morbidity Following Anatomic Lung Resection among Patients with COPD. Healthcare 2019, 7, 16.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Healthcare EISSN 2227-9032 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top