A Comparison of Outcome in Patient With and Without Undergoing Cardiopulmonary Exercise Testing (CPET)

Abstract

Background Cardiopulmonary exercise testing (CPET) is a preoperative risk stratification tool providing an objective measure of fitness and functional capacity. There is however little evidence on the use of this compared to non-physiological test in vascular surgery despite its current use. This study investigates whether CPET perioperatively has value alongside non-physiological testing for patients undergoing elective open abdominal aortic aneurysm (AAA) repair. Method Retrospective data was collected at 2 vascular centres between 2015-2019 in a CPET centre vs non-CPET centre in patients undergoing elective AAA repair. Outcomes measured included: length of stay in an intensive care unit (ICU); total length of stay; post-operative complications and acute kidney injury (AKI). Statistical analysis was performed using IBM SPSS software. Results There were 38 patients at each centre. The mean duration of stay in ICU for patients in CPET centre was 2.5 ± 2.13 days whilst in non-CPET centre it was 3.68 ± 4.08 days ( P = 0.05). The mean duration of stay in ICU and total length of stay was significantly shorter in CPET centre ( P = 0.05 and P = 0.015 respectively). Mortality in CPET centre was 2.63% and 5.26% in non-CPET centre (not significant). The number of patients developing AKI post-operatively was 13.61% in CPET vs 28.95% in non-CPET centre. Conclusion CPET tested patients have statistically significant lower length of total and ICU stay compared to non-CPET patients. CPET is therefore a useful adjunct in selecting patients for open surgery compared to non-physiological testing. This study provides some evidence on the use of this routinely but not validated assessment tool in aortic aneurysm repair.