Association of VO₂max With Postoperative Respiratory Complications in Patients Undergoing Lung Resection Surgery: An Exploratory Study

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Lung resection candidates (n=46). Intervention: Preoperative maximum oxygen consumption (VO₂max) vs. Lower VO₂max (evaluated as a continuous variable). Primary outcome: Early postoperative respiratory complications (within 14 days) (OR 0.58, 95% CI 0.39-0.85, p=0.005).

Q: What does this research mean for the field?

Higher preoperative VO₂max significantly reduces the risk of postoperative respiratory complications and 90-day mortality in patients undergoing lung resection surgery. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Gokul Govindasamy; Vinod Kumar Saka; Sreevathsa K. S. Prasad; Sandhiya Selvarajan; Pradeep S.; Vishnukanth Govindaraj

doi:10.7759/cureus.114377

August 11, 2026CureusOpen Access

Association of VO₂max With Postoperative Respiratory Complications in Patients Undergoing Lung Resection Surgery: An Exploratory Study

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Key result

Higher preoperative VO₂max is linked to ~42% lower odds of postoperative respiratory complications per unit.

OR 0.58
95% CI 0.39-0.85
P=0.005
n=46

Figures

Why the study?

Preoperative risk assessment is important in lung resection patients as postoperative respiratory complications and early mortality remain significant concerns, and VO₂max may help identify patients at increased perioperative risk.

Key Points

To assess whether preoperative maximum oxygen consumption (VO₂max) can predict early postoperative respiratory complications and 90-day mortality in patients undergoing lung resection.
Prospective observational study of 46 patients evaluated for lung resection at a single tertiary care center from January 2024 to November 2025.
Preoperative workup included spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), and cardiopulmonary exercise testing.
Recorded outcomes included postoperative respiratory complications within 14 days and all-cause mortality up to 90 days.
Early postoperative respiratory complications occurred in 4 of 46 patients (8.7%), who exhibited significantly lower median VO₂max than those without complications (8.91 vs. 16.34 mL/kg/minute, P = 0.002).
Each unit increase in VO₂max was associated with lower odds of postoperative respiratory complications (OR = 0.58; 95% CI: 0.39-0.85; P = 0.005).
Patients who died within 90 days had a significantly lower median VO₂max compared with survivors (7.8 vs. 16.21 mL/kg/minute, P = 0.007).

Study Design

Type

Observational (n=46)

Multicenter

No

Structured PICO

P

Population

46 adults (mean age 46.7 years, 39.1% female) undergoing lung resection surgery for various etiologies were evaluated with preoperative cardiopulmonary exercise testing and followed for up to 90 days.

E

Exposure

Preoperative cardiopulmonary exercise testing (CPET) to measure maximum oxygen consumption (VO₂max)

O

Outcome

Early postoperative respiratory complications (within 14 days), defined as a composite of delayed extubation (>12 hours) or re-intubation, atelectasis, pneumonia, pleural effusion, and respiratory failurecomposite

Main Result

Odds Ratio: 0.58 (95% CI 0.39–0.85)

p-value: p=0.005

Lower preoperative VO₂max is independently associated with an increased risk of early respiratory complications and 90-day mortality after lung resection surgery.

Limitations

Relatively small sample size limiting validation and statistical power
Inclusion of both malignant and non-malignant conditions might have introduced variability
Late postoperative events (>90 days) were not assessed
Low number of postoperative complication events limits the stability of the logistic regression estimates
Relatively small sample size limiting statistical power and generalizability
Included both malignant and non-malignant conditions, introducing variability
Low number of complication events limiting the stability of logistic regression estimates

Implication

May support VO₂max in preoperative risk assessment for lung resection; leaves open prospective validation of outcome impact.

Abstract

INTRODUCTION: Preoperative risk assessment is important in patients undergoing lung resection, as postoperative respiratory complications and early mortality remain significant concerns. Cardiopulmonary exercise testing provides an integrated assessment of functional capacity, and maximum oxygen consumption (VO₂max) reflects overall cardiopulmonary reserve. It may therefore help identify patients at increased perioperative risk. OBJECTIVE: The primary aim of the study was to predict early postoperative respiratory complications using preoperative VO₂max in subjects undergoing lung resection. The secondary aim was to assess 90-day postoperative mortality. METHODOLOGY: This prospective observational study was conducted in the department of pulmonary medicine, in collaboration with the department of cardiothoracic and vascular surgery and surgical oncology at a tertiary care center from January 2024 to November 2025. A total of 46 subjects were included for evaluation for lung resection. All subjects underwent preoperative spirometry and cardiopulmonary exercise testing. Postoperative respiratory complications were assessed during the early postoperative period, and mortality was recorded till 90 days. CONCLUSIONS: Lower preoperative VO₂max was observed in subjects who developed early (within 14 days) postoperative respiratory complications and in those who died within 90 days after lung resection. These findings suggest that preoperative VO₂max may help predict postoperative respiratory complications and mortality within 90 days.

Discussion

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Cite This Study

Govindasamy et al. (2026) conducted an observational in Lung resection candidates (n=46). Preoperative maximum oxygen consumption (VO₂max) vs. Lower VO₂max (evaluated as a continuous variable) was evaluated on Early postoperative respiratory complications (within 14 days) (OR 0.58, 95% CI 0.39-0.85, p=0.005). Higher preoperative VO₂max significantly decreased the risk of postoperative respiratory complications, with the odds of complications decreasing by 42% for each unit increase in VO₂max (OR 0.58).

synapsesocial.com/papers/6ad0fc963afa093ea9acfeac https://doi.org/10.7759/cureus.114377

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Association of VO₂max With Postoperative Respiratory Complications in Patients Undergoing Lung Resection Surgery: An Exploratory Study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Association of VO₂max With Postoperative Respiratory Complications in Patients Undergoing Lung Resection Surgery: An Exploratory Study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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