THE FEASIBILITY OF PREOPERATIVE 6-MINUTE WALK TEST FOR PREDICTING POSTOPERATIVE PULMONARY COMPLICATIONS OF THORACOTOMY

Abstract

Exercise testing is a reliable additional method to role pulmonary assessment prior to surgery of Thoracotomy patients. Supporting significant evidence is missing about routine and usual implementation of these simple tests in the field of preoperative evaluation.

The present study aims to test the feasibility of preoperative 6MWT for predicting postoperative pulmonary complications of Thoracotomy. The secondary aim is to test the validity of Enright and Sherill’s equation as reference equation to calculate the predicted 6MWD.

Between November 2018 and October 2019, thirty-six patients with an indication for thoracotomy underwent their surgery. Demographic data were collected, spirometry ,6MWT were performed 1 day before thoracotomy, Total walking distance, oxygen saturation decline, heart rate recovery, dyspnea grade, degree of BP change, postoperative length of stay in hospital were all evaluated, then detection and follow up of postoperative pulmonary complication was done.

Out of 36 cases studied 21 were males and 15 females with a mean age of 42 years. All surgeries were done by just 2 surgeons A 6MWD of 500 m and 100% of the predicted 6MWD were taken as threshold values to differentiate the risk of postoperative pulmonary complications in the studied groups, The cut-off value of 500 m classified the studied patients into 2 groups with an increased risk of postoperative complications in group A than group B [26.3% vs 0 %, P-value 0.023 showing significant difference between the 2 groups regarding the appearance of post-operative pulmonary complication so group A shows 5 patients (26.3%) had post-operative pulmonary complications, 1 patient had post-operative aspiration and edema, 2 patients had post-operative empyema & Respiratory Failure (RF), 1 patient had post-operative RF, mechanical ventilation & died, 1 patient had post-operative hemorrhage . analysis of pre-walk and post-walk values of the 6MWT between studied groups revealed significant tachypnea, oxygen desaturation and worsening of dyspnea grade among those walked ≤500 m and had ≤ 100% of predicted test value (group A) when compared with those walked >500 m and had > 100% of predicted test value (group B) and also in the degree (Δ) of change between pre walk and post walk value .