Key result
Preoperative physiological capacity outperforms ASA rank in predicting postoperative morbidity with an AUC of ~0.83.
Why the study?
The study compared the risk predictive value of preoperative physiological capacity with the ASA physical status classification for postoperative morbidity after major abdominal cancer surgery.
Does preoperative physiological capacity measured by cardiopulmonary exercise testing predict postoperative morbidity better than the ASA physical status classification in patients undergoing major abdominal cancer surgery?
Population
32 patients undergoing major abdominal cancer surgery
Comparison
Preoperative physiological capacity vs ASA physical status classification
Design
Pilot observational study with logistic regression and ROC analysis
Authors
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May support CPET for preoperative risk stratification in abdominal cancer surgery; hypothesis-generating and requires prospective validation.
Observational (n=32)
Does preoperative physiological capacity measured by cardiopulmonary exercise testing predict postoperative morbidity better than the ASA physical status classification in patients undergoing major abdominal cancer surgery?
Effect estimate: AUC 0.826
p-value: p=0.023
Preoperative physiological capacity measured by cardiopulmonary exercise testing may improve predictive sensitivity for postoperative morbidity compared to the standard ASA physical status classification in major abdominal surgery.
Hightower et al. (2010) conducted an observational in major abdominal cancer surgery (n=32). Preoperative physiological capacity (PC) vs. ASA physical status classification system was evaluated on postoperative morbidity (AUC 0.826, p=0.023). Preoperative physiological capacity predicted postoperative morbidity with an AUC of 0.826 (P=0.023), while the ASA rank predicted it with an AUC of 0.688 (P=0.038).
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