Outcome prediction following CPET and oesophagogastric surgery
Research type
Research Study
Full title
Cardiopulmonary exercise variables and their association with postoperative morbidity and mortality after major oesophagogastric cancer surgery – A multicentre observational study
IRAS ID
228915
Contact name
Denny Levett
Contact email
Sponsor organisation
University Hospitals Southampton NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Major upper gastrointestinal surgery carries substantial risk of complications (up to 50%) and death, particularly in elderly patients and those with medical problems. Outcome after major surgery depends on modifiable factors such as the medical care received before, during and after surgery, as well as the tolerance of surgical trauma by the body. Accurate risk stratification permits modification of preoperative patient status as well as optimisation of intra- and postoperative management, and thus facilitates efficient use of hospital resources (e.g. intensive care and ward beds), and enhances shared decision making.
Cardiopulmonary exercise testing (CPET) has been used for risk stratification before in thoracic and abdominal surgery. This tests the cardiorespiratory reserve (physical fitness) at rest and under the stress of maximal exercise (mimicking that of major surgery), and is the most objective and precise means of evaluating presurgical fitness.
The present study is a retrospective analysis of prospectively collected clinical data. Anonymized data from patients collected during routine clinical care from 8 units in the United Kingdom who undergo upper gastrointestinal (UGI) cancer surgery and perform pre-operative cardiopulmonary exercise testing will be interrogated. Anonymised data will be pooled at a central location (University Hospitals Southampton) and used to investigate the relationship between selected cardiopulmonary exercise testing (CPET) variables, in-hospital post-operative and survival outcomes after major UGI cancer surgery.
Our primary aim is to establish a reliable relationship between post-operative overall survival and oxygen uptake (Vo2) at peak exercise (Vo2 Peak); a secondary aim is to explore the multivariable relationship between selected CPET variables especially Vo2 at the estimated lactate threshold/anaerobic threshold (LT), together with other selected CPET derived variables, and other important prognostic variables with post-operative complications (in-hospital morbidity and 1-year mortality) in an attempt to risk stratify patients before major UGI surgery.
REC name
South Central - Oxford C Research Ethics Committee
REC reference
17/SC/0331
Date of REC Opinion
26 Jun 2017
REC opinion
Favourable Opinion