Background. The objective of this study was to identify the predictors of underestimation and overestimation of postoperative maximum oxygen consumption (V̇o2max). Methods. A prospective analysis was performed on 229 patients who had 38 pneumonectomies, 171 lobectomies, and 20 segmentectomies. All patients performed a preoperative and postoperative (on average 9.2 days after surgery) maximal stair-climbing test. Predicted postoperative V̇o2max (ppoV̇o2max) was calculated on the basis of the number of functioning segments removed during operation. The patients were divided into three groups: group A (158 cases), patients with a ppoV̇o2max within 1 standard deviation of the observed postoperative V̇o2max; group B (56 cases), patients with a difference between the observed postoperative V̇o2max and ppoV̇o2max greater than 1 standard deviation (underestimation); and group C (15 cases), patients with a difference between ppoV̇o2max and the observed postoperative V̇o2max greater than 1 standard deviation (overestimation). Univariate and multivariate analyses were performed. Results. The only significant predictor of underestimation was a high percentage of functional parenchyma removed during operation (p <0.0001). The significant predictors of overestimation were a low percentage of functional parenchyma removed during operation (p = 0.01) and a high preoperative V̇o2max (p = 0.002). Conclusions. The prediction of postoperative V̇o2max was not accurate in all patients. Those with a large amount of functional lung tissue removed during operation tended to have a postoperative V̇o2max greater than expected. Conversely, those patients with a small amount of functional lung tissue resected tended to have a postoperative V̇o2max lower than predicted.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine