The impact of Cardiopulmonary Exercise Testing (CPET) on patients over 80 years undergoing elective colorectal cancer surgery

2.50
Hdl Handle:
http://hdl.handle.net/11287/593974
Title:
The impact of Cardiopulmonary Exercise Testing (CPET) on patients over 80 years undergoing elective colorectal cancer surgery
Authors:
Chan, Katie E.; Pathak, Samir; Smart, Neil J. ( 0000-0002-3043-8324 ) ; Batchelor, N.; Daniels, Ian R. ( 0000-0002-9114-0812 )
Abstract:
AIM: Advanced age and occult cardiorespiratory disease are associated with increased morbidity and mortality following surgery. Cardiopulmonary exercise testing (CPET) may allow identification of high risk patients and facilitate planned postoperative critical care support. The aim of the study was to determine whether pre-operative CPET testing in patients over 80 years undergoing elective colorectal cancer resection was associated with improved outcome. METHOD: All patients aged 80 years and above undergoing elective colorectal cancer resection between 1st March 2011 and 1st September 2013 were retrospectively analysed. Referral for CPET testing was at the discretion of the operating surgeon. Postoperative critical care unit (CCU) admission was based upon the CPET results. RESULTS: Ninety-four patients were identified of whom 48 underwent CPET testing. The CPET group were significantly older than the non-CPET group (85 vs 83 years P=0.04) and were more likely to have a planned admission to CCU postoperatively (P<0.0001). Despite the increased use of CCU resources the overall CCU LOS in the CPET group did not differ from the non-CPET group, but the non-CPET group had a higher proportion of level 3 care. There were no differences in the incidence of unplanned CCU admission between the CPET and the non-CPET group (p=0.23). There were no differences in overall length of stay (LOS) between the two groups (P=0.42). There was no difference in mortality (P=0.11), overall complications (p=0.53) and severe complications (P=0.3). CONCLUSION: Pre-operative CPET testing in patients over 80 years undergoing elective colorectal cancer resection allows identification of higher risk patients and mitigation of risk by pre-emptive CCU admission. This stratification allows equivalent results to be achieved in high and low risk elderly patients undergoing colorectal surgery. This article is protected by copyright. All rights reserved.
Citation:
Colorectal Dis. 2015 Sep 28.
Publisher:
Wiley
Journal:
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
Issue Date:
28-Sep-2015
URI:
http://hdl.handle.net/11287/593974
DOI:
10.1111/codi.13139
PubMed ID:
26417705
Additional Links:
http://dx.doi.org/10.1111/codi.13139
Type:
Journal Article
Language:
Eng
ISSN:
1463-1318
Appears in Collections:
2015 RD&E publications; HeSRU publications

Full metadata record

DC FieldValue Language
dc.contributor.authorChan, Katie E.en
dc.contributor.authorPathak, Samiren
dc.contributor.authorSmart, Neil J.en
dc.contributor.authorBatchelor, N.en
dc.contributor.authorDaniels, Ian R.en
dc.date.accessioned2016-01-19T12:38:09Zen
dc.date.available2016-01-19T12:38:09Zen
dc.date.issued2015-09-28en
dc.identifier.citationColorectal Dis. 2015 Sep 28.en
dc.identifier.issn1463-1318en
dc.identifier.pmid26417705en
dc.identifier.doi10.1111/codi.13139en
dc.identifier.urihttp://hdl.handle.net/11287/593974en
dc.description.abstractAIM: Advanced age and occult cardiorespiratory disease are associated with increased morbidity and mortality following surgery. Cardiopulmonary exercise testing (CPET) may allow identification of high risk patients and facilitate planned postoperative critical care support. The aim of the study was to determine whether pre-operative CPET testing in patients over 80 years undergoing elective colorectal cancer resection was associated with improved outcome. METHOD: All patients aged 80 years and above undergoing elective colorectal cancer resection between 1st March 2011 and 1st September 2013 were retrospectively analysed. Referral for CPET testing was at the discretion of the operating surgeon. Postoperative critical care unit (CCU) admission was based upon the CPET results. RESULTS: Ninety-four patients were identified of whom 48 underwent CPET testing. The CPET group were significantly older than the non-CPET group (85 vs 83 years P=0.04) and were more likely to have a planned admission to CCU postoperatively (P<0.0001). Despite the increased use of CCU resources the overall CCU LOS in the CPET group did not differ from the non-CPET group, but the non-CPET group had a higher proportion of level 3 care. There were no differences in the incidence of unplanned CCU admission between the CPET and the non-CPET group (p=0.23). There were no differences in overall length of stay (LOS) between the two groups (P=0.42). There was no difference in mortality (P=0.11), overall complications (p=0.53) and severe complications (P=0.3). CONCLUSION: Pre-operative CPET testing in patients over 80 years undergoing elective colorectal cancer resection allows identification of higher risk patients and mitigation of risk by pre-emptive CCU admission. This stratification allows equivalent results to be achieved in high and low risk elderly patients undergoing colorectal surgery. This article is protected by copyright. All rights reserved.en
dc.language.isoEngen
dc.publisherWileyen
dc.relation.urlhttp://dx.doi.org/10.1111/codi.13139en
dc.titleThe impact of Cardiopulmonary Exercise Testing (CPET) on patients over 80 years undergoing elective colorectal cancer surgeryen
dc.typeJournal Articleen
dc.identifier.journalColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Irelanden

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