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Stair Climbing Test Predicts Cardiopulmonary Complications After Lung Resection^*

^* From the Department of Thoracic Surgery, University of Ancona, Ancona, Italy.

Correspondence to: Alessandro Brunelli, MD, Via S. Margherita 23, Ancona 60129, Italy; e-mail: alexit_2000{at}yahoo.com

Study objective: To evaluate the capability of the stair climbing test to predict cardiopulmonary complications after lung resection for lung cancer.

Design: A prospective cohort of candidates for lung resection. Spirometric assessment and the stair climbing test were performed the day before operation. Univariate and multivariate analyses were performed to identify predictors of postoperative complications.

Setting: Tertiary referral center.

Patients: A consecutive series of 160 candidates for lung resection with lung carcinoma from January 2000 through March 2001.

Results: At univariate analysis, the patients with complications were significantly older (p = 0.02), had a significantly lower FEV₁ percentage (p = 0.007) and predicted postoperative FEV₁ percentage (p = 0.01), had a greater incidence of a concomitant cardiac disease (p = 0.02), climbed a lower altitude at the stair climbing test (p < 0.0001), and had a lower calculated maximum oxygen consumption (O₂max) [p = 0.03] and predicted postoperative O₂max (p = 0.006) compared to the patients without complications. At multivariate analysis, the altitude reached at the stair climbing test remained the only significant independent predictor of complications.

Conclusions: The stair climbing test is a safe and economical exercise test, and it was the best predictor of cardiopulmonary complications after lung resection.

Key Words: complication • exercise test • lung resection • maximum oxygen consumption • stair climbing test

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