Surgical risk stratification in

complex colorectal patients

596: P. Vasas, R. Cohen, A. Windsor; University College London Hospitals NHS Foundation Trust

Perioperative mortality rate in major colorectal surgery: 2-5.6%

Aim: Examine the efficacy of of cardio-pulmonary exercise testing (CPET) as a

ml/min/kg
method of determining cardiopulmonary reserve in colorectal patients.
CPET provides an assessment of the global responses of the pulmonary,
cardiovascular and haematological systems.
30 Anaerobic Threshold (AT)
25 max, mlsKg-1min-1
20
50
1545
10
30
5 25
20 360 watts
0 15
10
5 0 60 120 180 240 300 360 420
watts
0
0
ASGBI annual meeting, Glasgow 420
13-15 May 2009
 Surgical risk stratification in
complex colorectal patients
AT distribution

Patients and methods:

30

Duration: 16 months (May 2007 - Aug 2008)

Involved patients: 252
20

Frequency
Age (mean + SD): 55.03+17.18 years
Gender distribution: 111 female (44%) and 141 male (56%) 10

Operation distribution: minor: 2 (0.8%)

major primary: 96 (38.1%)
Mean =14,22
Std. Dev. =4,
232
0 N =159
5,00 10,00 15,00 20,00 25,00 30,00 35,00
Measured AT

major redo 142 (56.3%)

enterocutaneous fistula 12 (4.8%)
AT groups
AT<11 AT>11 not able not tested
Count Mean age Count Mean age Count Mean age Count Mean age
Patients 37 54.49 122 54.56 23 62.70 65 53.17

Relativeriskof Cardiopulmonarycomplication
Results I: 0.15

0.10

0.05

0.00
AT<11 AT>11 not able not tested
Groups
 Surgical risk stratification in
complex colorectal patients
Results II:

p=0.042 Area under curve: 0.67

Conclusion: CPX appears to allow appropriate triage of colorectal patient