Performance in 6-min walk test in prediction of post-operative pulmonary complication in major oncosurgeries: A prospective observational study

Abstract

Background and Aims: Post-operative pulmonary complications (PPC) contribute to increased morbidity and mortality, necessitating pre-operative functional assessment. Six-minute walk test (6MWT) is a simple option for functional assessment. Methods: This is a prospective observational study conducted in 75 patients who underwent elective abdominal or thoracic oncosurgery under general anaesthesia with either age above 60 years or with cardiopulmonary diseases or obstructive sleep apnoea or low serum albumin or smoking. Patients with history of acute coronary syndrome in past 6 months, dyspnoea at rest, severe pain, inability to walk or interpret instructions and haemodynamic instability were excluded. Preoperatively 6MWT was conducted according to the American Thoracic Society guidelines and patients were observed for PPC. Patients were divided into two groups: group 1–no PPC and group 2–developed PPC. Statistical analysis was done using SPSS software (version 11.0.1). Categorical variables were assessed using Chi-square/Fisher's exact test and continuous variables using student's t-test/Mann-Whitney U test. Association was tested using logistic regression. Results: Out of the 75 patients, 40 patients had no PPC (group 1) and 35 patients had PPC (group 2) including a death. The 6MWD of group with PPCs was significantly less (344 ± 61.927 m) compared to the group without PPCs (442.28 ± 83.194 m, P value = 0.001). The cut-off 6MWD obtained was 390 m, which correlated with longer duration of hospital stay and ICU stay (P = 0.001). Conclusion: Six-minute walk test is a reliable predictor of post-operative pulmonary complications with a cut-off 6MWD of 390 m in the studied oncosurgery patients.

Keywords

• exercise test
• oncosurgery
• perioperative care
• post-operative complications
• prospective studies
• walk test