prikaz prve stranice dokumenta Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients
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Scientific paper - Original scientific paper
Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients
Croatian Medical Journal, 49 (2008), 1; 50-57. https://doi.org/10.3325/cmj.2008.1.50
Nikolić, Igor; Majerić-Kogler, Višnja; Plavec, Davor; Maloča, Ivana; Slobodnjak, Zoran

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Nikolić, I., Majerić Kogler, V., Plavec, D., Maloča, I. & Slobodnjak, Z. (2008). Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients. Croatian Medical Journal, 49. (1), 50-57. doi: 10.3325/cmj.2008.1.50

Nikolić, Igor, et al. "Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients." Croatian Medical Journal, vol. 49, no. 1, 2008, pp. 50-57. https://doi.org/10.3325/cmj.2008.1.50

Nikolić, Igor, Višnja Majerić Kogler, Davor Plavec, Ivana Maloča and Zoran Slobodnjak. "Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients." Croatian Medical Journal 49, no. 1 (2008): 50-57. https://doi.org/10.3325/cmj.2008.1.50

Nikolić, I., et al. (2008) 'Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients', Croatian Medical Journal, 49(1), pp. 50-57. doi: 10.3325/cmj.2008.1.50

Nikolić I, Majerić Kogler V, Plavec D, Maloča I, Slobodnjak Z. Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients. Croatian Medical Journal [Internet]. 2008 February [cited 2024 May 03];49(1):50-57. doi: 10.3325/cmj.2008.1.50

I. Nikolić, V. Majerić Kogler, D. Plavec, I. Maloča and Z. Slobodnjak, "Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients", Croatian Medical Journal, vol. 49, no. 1, pp. 50-57, February 2008. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:105:560340. [Accessed: 03 May 2024]

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Title (english)Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients
AuthorIgor Nikolić
AuthorVišnja Majerić-Kogler
AuthorDavor Plavec
AuthorIvana Maloča
AuthorZoran Slobodnjak
Author's institutionUniversity of Zagreb
School of Medicine
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Abstract (english)
AIM: To test the predictive value of stairs climbing test for the development of postoperative complications in lung cancer patients with forced expiratory volume in one second (FEV1)<2 L, selected for an elective lung surgery. ----- METHODS: The prospective study was conducted in 101 consecutive patients with an FEV1<2 L selected for elective lung surgery for lung cancer. Preoperative examination included medical history and physical examination, lung function testing, electrocardiography, laboratory testing, and chest radiography. All patients underwent stairs climbing with pulse oximetry before the operation with the number of steps climbed and the time to complete the test recorded. Oxygen saturation and pulse rate were measured every 20 steps. Data on postoperative complications including oxygen use, prolonged mechanical ventilation, and early postoperative mortality were collected. ----- RESULTS: Eighty-seven of 101 patients (86%) had at least one postoperative complication. The type of surgery was significantly associated with postoperative complications (25.5% patients with lobectomy had no early postoperative complications), while age, gender, smoking status, postoperative oxygenation, and artificial ventilation were not. There were more postoperative complications in more extensive and serious types of surgery (P<0.001). The stairs climbing test produced a significant decrease in oxygen saturation (-1%) and increase in pulse rate (by 10/min) for every 20 steps climbed. The stairs climbing test was predictive for postoperative complications only in lobectomy group, with the best predictive parameter being the quotient of oxygen saturation after 40 steps and test duration (positive likelihood ratio [LR], 2.4; 95% confidence interval [CI], 1.71-3.38; negative LR, 0.53; 95% CI, 0.38-0.76). In patients with other types of surgery the only significant predictive parameter for incident severe postoperative complications was the number of days on artificial ventilation (P=0.006). ----- CONCLUSION: Stairs climbing test should be done in routine clinical practice as a standard test for risk assessment and prediction of the development of postoperative complications in lung cancer patients selected for elective surgery (lobectomy). Comparative to spirometry, it detects serious disorders in oxygen transport that are a baseline for a later development of cardiopulmonary postoperative complications and mortality in this subgroup of patients.
Abstract (croatian)
CILJ: Procijeniti prediktivnu vrijednost testa uspinjanja uza stube za razvitak poslijeoperacijeskih komplikacija u bolesnika s rakom pluća koji su odabrani za elektivnu operaciju, a u kojih je forsirani izdisajni volumen u prvoj sekundi (FEV1) manji od 2 L. ----- POSTUPCI: Prospektivno složeno istraživanje provedeno je u 101 bolesnika redom kako su dolazili, pod uvjetom da su imali FEV1<2 L i bili odabrani za elektivnu resekciju pluća zbog plućnoga zloćudnog tumora. Preoperacijski pregled obuhvatio je anamnezu i fizikalni pregled, ispitivanje plućnih funkcija, EKG, laboratorijske testove i rendgensku sliku pluća. Svi su prije operacije podvrgnuti testu uspinjanja uza stube s pulsnom oksimetrijom gdje im je mjeren broj stuba koje su svladali i vrijeme potrebno za dovršenje testa. Zasićenje krvi kisikom i frekvencija pulsa mjereni su svakih 20 stuba. Poslijeoperacijske komplikacije procijenjene su u odnosu na davanje kisika, produljenje mehaničke ventilacije i ranu smrtnost. ----- REZULTATI: Najmanje jedna poslijeoperacijska komplikacija pojavila se u 87 (86%) bolesnika. Vrsta operacije bila je značajno povezana s poslijeoperacijskim komplikacijama (25.5% bolesnika s lobektomijom nije imalo ranih poslijeoperacijskih komplikacija), a dob, spol, pušenje cigareta, poslijeoperacijska oksigenacija i mehanička ventilacija nisu. Više je komplikacija bilo nakon većih i ozbiljnijih operacija (P<0,001). Test uspinjanja uza stube izazivao je značajno sniženje zasićenja krvi kisikom (-1%) i povišenje frekvencije pulsa (10/minute) nakon svladanih svakih 20 stuba. Test je upućivao na poslijeoperacijske komplikacije samo u bolesnika s lobektomijom, pri čemu je najjači prediktor bio kvocijent zasićenja kisikom nakon 40 stuba i trajanje testa (+omjer vjerojatnosti [likelihood ratio, LR], 2,4; 95% raspon pouzdanosti [confidence interval, CI], 1,71- 3,38; -LR, 0,53; 95% CI, 0,38-0,76). Jedini značajan prediktor za incidentne poslijeoperacijske komplikacije u bolesnika s drugim vrstama operacije bio je broj dana provedenih na mehaničkoj ventilaciji (P=0,006). ----- ZAKLJUČAK: Test uspinjanja uza stube treba primijeniti u rutinskoj kliničkoj praksi kao standardni test za procjenu rizika i predviđanje razvoja poslijeoperacijskih komplikacija u bolesnika s rakom pluća koji su odabrani za elekrivnu resekciju pluća (lobektomiju). Za razliku od spirometrije, taj test otkriva ozbiljnije poremećaje prijenosa kisika koji su osnova susljednom razvitku kardiopulmonarnih poslijeoperaciskih komplikacija u toj podskupini bolesnika.
Keywords (english)
Languageenglish
Publication typeScientific paper - Original scientific paper
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleCroatian Medical Journal
Numberingvol. 49, no. 1, pp. 50-57
p-ISSN0353-9504
DOIhttps://doi.org/10.3325/cmj.2008.1.50
URN:NBNurn:nbn:hr:105:560340
Publication2008-02
Document URLhttp://www.cmj.hr/2008/49/1/18293457.htm
Type of resourceText
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2024-03-28 10:07:23