Key result
Self-reported poor functional capacity predicts ~445% higher postoperative pulmonary complication risk, making stair tests dispensable.
Why the study?
It was unknown whether preoperative stair-climbing tests predict postoperative pulmonary complications better than self-reported poor functional capacity in patients with known or suspected COPD.
Do preoperative stair-climbing tests predict postoperative pulmonary complications better than self-reported poor functional capacity in patients with known or suspected COPD undergoing major non-cardiac surgery?
Observational (n=320)
Do preoperative stair-climbing tests predict postoperative pulmonary complications better than self-reported poor functional capacity in patients with known or suspected COPD undergoing major non-cardiac surgery?
Self-reported poor functional capacity adequately predicts postoperative pulmonary complications in patients with known or suspected COPD, making additional stair-climbing tests dispensable.
Self-reported functional capacity may suffice for PPC risk stratification in COPD surgery patients; this Level 3 cohort finding leaves open the need for prospective validation.
Background: This prospective study aims to determine whether preoperative stair-climbing tests (SCT) predict postoperative pulmonary complications (PPC) better than self-reported poor functional capacity (SRPFC) in patients with known or suspected COPD. Methods: A total of 320 patients undergoing scheduled for major non-cardiac surgery, 240 with verified COPD and 80 with GOLD key indicators but disproved COPD, underwent preoperative SRPFC and SCT and were analyzed. Least absolute shrinkage and selection operator (LASSO) regression was used for variable selection. Two multivariable regression models were fitted, the SRPFC model (baseline variables such as sociodemographic, surgical and procedural characteristics, medical preconditions, and GOLD key indicators plus SRPFC) and the SCT model (baseline variables plus SCTPFC). Results: Within all stair-climbing variables, LASSO exclusively selected self-reported poor functional capacity. The cross-validated area under the receiver operating characteristic curve with bias-corrected bootstrapping 95% confidence interval (95% CI) did not differ between the SRPFC and SCT models (0.71; 0.65–0.77 for both models). SRPFC was an independent risk factor (adjusted odds ratio (OR) 5.45; 95% CI 1.04–28.60; p = 0.045 in the SRPFC model) but SCTPFC was not (adjusted OR 3.78; 95% CI 0.87–16.34; p = 0.075 in the SCT model). Conclusions: Our findings indicate that preoperative SRPFC adequately predicts PPC while additional preoperative SCTs are dispensable in patients with known or suspected COPD.
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Dankert et al. (2023) conducted an observational in Known or suspected COPD (n=320). Self-reported poor functional capacity (SRPFC) vs. Stair-climbing tests (SCT) was evaluated on Postoperative pulmonary complications (PPC) (OR 5.45, 95% CI 1.04-28.60, p=0.045). Preoperative self-reported poor functional capacity predicted postoperative pulmonary complications (adjusted OR 5.45; 95% CI 1.04-28.60; p=0.045), making additional stair-climbing tests dispensable.
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