Cardiopulmonary Exercise Testing Predicting Postoperative Morbidity in Patients with Pulmonary Resection

The aim of this study was to analyze which variables obtained during the Cardiopulmonary Exercise Testing (CPET) are related to postoperative complications after lung surgery resection. Retrospective observational study included patients that underwent preoperative surgical stratification by CPET between 2010 and 2019. A total of 100 patients (88 men) were studied. With a mean age of 65.89 ± 7.3 years. The mean ± sd in the different results were: FVC%: 68.47 ± 13.15; FEV1%: 54.18 ± 13.57; DLCO%: 61.84 ± 16.87. VO2/ kg max: 15.68 ± 3.34 ml /kg/min. VO2 max%: 64.14 ± 12.67%; RER max: 1.04 ± 0.15. EqCO2 (AT): 37.95 ± 26.58. The mean Charlson Index was 5.29 ± 1.38. 48 patients underwent atypical resection, 44 a lobectomy, 8 a pneumonectomy. In 39 patients, the histological diagnosis was adenocarcinoma, in 35 squamous cell carcinoma, 10 presented another type of lung cancer and in 16 no evidence of neoplasia was found. 36% presented postoperative complications, the most frequent were prolonged air leak (9) and subcutaneous emphysema (9). There were 5 cases of pneumothorax, 3 of pneumonia, 2 of hemorrhages and only 1 case of death. The mean number of days of hospitalization was 7 ± 6.7. From the CPET, only with the RER max. we obtained a statistically significant result in the prediction of postoperative complications, but not in all subjects such value could be obtained, because some did not reach the maximum effort. The lung cancer staging also showed a relationship with the frequency of complications. The number of days of hospitalization was also higher in patients with complications. Our results showed that the RERmax is valid as a predictor of postoperative complications.