Stair Climbing Test Predicts Cardiopulmonary Complications After Lung Resection

Brunelli, Alessandro; Refai, Majed; Monteverde, Marco; Borri, Alessandro; Salati, Michele; Fianchini, Aroldo

doi:10.1378/chest.121.4.1106

Cited by 148 publications

(97 citation statements)

References 27 publications

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“…The use of stairclimbing tests for the selection of patients might therefore contribute to a decreased incidence of postoperative complications. 19,20) As for the outcomes of resection in our study, the 5-year survival rate was 68.6%, with a mean survival time of 109.2 months. These results compare favorably with those of previous studies of surgical outcomes in stage I NSCLC (Table 3).…”

Section: Discussionmentioning

confidence: 64%

Outcomes of Lobectomy in ‘Active’ Octogenarians with Clinical Stage I Non-Small-Cell Lung Cancer

Ito

Nakayama

Yamada

et al. 2015

ATCS

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Introduction: In octogenarians with early stage of lung cancer, sublobar resection has been shown to be no inferior survival to lobectomy. However, some octogenarians remain physically and mentally active. Methods: We retrospectively studied 65 octogenarians who underwent curative resection for clinical stage I NSCLC (excluding adenocarcinoma in situ). All patients were assessed by cardiologists and underwent stair-climbing tests (five flights, 18 m) and cognitive function tests. Lobectomy was performed in patients who could climb 5 flights of stairs without stopping or oxygen desaturation of >4%. Results: The actuarial survival rate was 68.6% at 5 years, and the median survival time was 109.2 months. Forty-three patients met the criteria for lobectomy. As compared with sublobar resection, lobectomy was associated with significantly higher rates of overall survival (78.4% vs. 48.5%; p = 0.02) and disease-specific survival (88.4% vs. 61.7%; p = 0.02) at 5 years. On multivariate analysis, male sex (hazard ratio, 3.827; 1.382-10.596) and sublobar resection (2.261; 1.054-5.360) were independent risk factors for survival. Mental disorders occurred in 6 patients (9.2%), and their score on preoperative cognitive function tests was significantly lower than that of patients without mental disorders (22.7 vs. 26.0, p <0.01). Conclusion: Outcomes of lobectomy are good in physically and mentally competent octogenarians.

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Section: Discussionmentioning

confidence: 64%

Outcomes of Lobectomy in ‘Active’ Octogenarians with Clinical Stage I Non-Small-Cell Lung Cancer

Ito

Nakayama

Yamada

et al. 2015

ATCS

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“…However, studies to date have been limited by heterogeneity of stair climbing protocols and inadequate control of confounding factors [9,[17][18][19][20]. This study overcame some of these limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, stair climbing can provide economical aerobic training without specialized equipment [17][18][19][20] and has been recommended to alleviate America's and Europe's obesity epidemic [1,6,9,17]. However, studies to date have been limited by heterogeneity of stair climbing protocols and inadequate control of confounding factors [9,[17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Stair Climbing Protocols for Smokers

Giménez¹,

Saavedra²

2017

IJRDM

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“…Subsequently, we reported our preliminary experience on 160 lung resection candidates [19]. We found that the altitude reached during pre-operative stair climbing test was the only independent predictor of cardiopulmonary complications after controlling the effect of other variables by logistic regression analysis.…”

Section: Stair Climbingmentioning

confidence: 90%

“…In some studies, the time to complete the test is recorded and used to estimate the VO 2 peak based on modified equations [18,19].…”

Section: Stair Climbingmentioning

confidence: 99%

Low-technology exercise test in the preoperative evaluation of lung resection candidates

Brunelli¹,

Pompili²,

Salati³

2016

Monaldi Arch Chest Dis

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Exercise tests are increasingly used in the preoperative functional evaluation of lung resection candidates. Low-technology exercise tests include six minute walking, shuttle walking and stair climbing. Conflicting evidence has been reported regarding 6 minute walking test. This test should not be used to select patients for lung resection. An incremental shuttle walk test is easier to replicate than 6 minute walking test. Most patients achieving 25 shuttles or 400 m have a maximum oxygen consumption measured at cardiopulmonary exercise test greater than 15 l/Kg/min. Although this test tends to underestimate performance at the lower range compared to peak oxygen consumption it can be used a screening test before lung resection. Excluding patients from operation based on this test alone is however not recommended and a formal cardiopulmonary exercise test should be always used in those walking less than 400 m. Stair climbing has been extensively studied in thoracic surgery. Several studies have found that poor performance in this test is indicative of cardiopulmonary complications and mortality after lung resection. In particular, climbing less than 12 m represents very high risk, whereas climbing more than 22 m is associated with a favourable outcome. Recent guidelines recommend referring all patients climbing lower than 22 m to cardiopulmonary exercise test. Stair climbing can be used as a screening test in cases cardiopulmonary exercise test is not readily available. In general, patients climbing more than 22 m can proceed to surgery without further evaluation.

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Stair Climbing Test Predicts Cardiopulmonary Complications After Lung Resection

Cited by 148 publications

References 27 publications

Outcomes of Lobectomy in ‘Active’ Octogenarians with Clinical Stage I Non-Small-Cell Lung Cancer

Outcomes of Lobectomy in ‘Active’ Octogenarians with Clinical Stage I Non-Small-Cell Lung Cancer

Comparison of Two Stair Climbing Protocols for Smokers

Low-technology exercise test in the preoperative evaluation of lung resection candidates

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