OBJECTIVE To assess whether a test of stair climbing ability could be used to predict the risk of developing postoperative cardiopulmonary complications in patients undergoing general anesthesia. DESIGN Cohort study. PLACE AND DURATION OF STUDY The Aga Khan University Hospital, Karachi. The duration of the study was from December 2003 to December 2004. PATIENTS AND METHODS This study was carried out on consecutive, adult patients presenting for elective thoracic or abdominal surgery under general anesthesia. Pre-operatively, patients were asked to climb a standard staircase. Number of steps climbed was recorded. Those unable to climb stairs due to debilitating cardiac, pulmonary or rheumatologic disease were categorized as 0 stairs climbed. Outcome variables were postoperative cardiopulmonary complications or mortality. Period of follow-up was until hospital discharge. RESULTS Seventy-eight patients were enrolled, 59 (75.6%) climbed 1 flight of stairs, 19 (24.3%) climbed < 1 flight. All-cause cardiopulmonary complications rate was 26 %. The most frequent complication was lobar atelectasis, followed by bronchospasm and acute MI. The complication rate was 22.8% in those able to climb 1 flight and 40% in those patients who climbed < 1 flight. The group that climbed < 1 flight tended to have complications associated with poor reserves of the cardiopulmonary systems, i.e. pulmonary edema, exacerbation of underlying lung disease. The relative risk of developing complications, if unable to climb at least 1 flight of stairs, was calculated to be 1.8 (95% CI 0.7 - 4.6). CONCLUSION Stair climbing can be a useful pre-operative tool to predict the risk of postoperative cardiopulmonary complications.

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Predicting postoperative cardio-pulmonary complications by a test of stair climbing.

In order to determine the relationship between pulmonary function, performance on stair climbing, pre- and post-exercise arterial blood gases and post thoracotomy complications, we performed a prospective study on 19 patients. Sixteen of seventeen patients could accomplish a five flight stair climb. All of the seventeen patients survived and could be weaned off the respirator. Four developed postoperative complications. MMEFP (per cent mid maximum expiratory flow) showed statistically significant differences between patients with and without complications.

Boonkasem S

Papers

Stair climbing, pre- and post-exercise arterial blood gases, and pulmonary function for pre-operative evaluation.