Impaired cardiopulmonary reserve in an elderly population is related to postoperative morbidity and length of hospital stay after radical cystectomy

摘要: Objective To determine the relationship of preoperatively measured cardiorespiratory function, to development postoperative complications and length hospital stay (LOS) in a cohort patients undergoing radical cystectomy (RC), as RC conduit formation is curative but associated with significant morbidity mortality. Patients Methods Consecutive planned have underwent cardiopulmonary exercise testing (CPET) standardised protocol. The results CPET were ‘blinded’ from clinicians involved care patients. Patients prospectively monitored for primary outcome complications, defined by validated classification (Clavien-Dindo). Secondary included LOS mortality. Results In all, 82 before RC. Eight did not subsequently undergo further five sufficiently allow appropriate determination variables interest. There was difference between those who had major perioperative complication (Clavien score > 3) that (16 vs 30 days; P < 0.001; hazard ratio [HR] 3.6, 95% confidence interval [CI] 2.1–6.3). The anaerobic threshold (AT) remained only independent predictor variable presence or absence (odds 0.74, CI 0.57–0.97; = 0.03). When optimal predictive value AT 12 mL/min/kg used fitness marker, there (median LOS: ‘unfit’ 22 days ‘fit’ 16 HR 0.47, 0.28–0.80; 0.006) Conclusion Impaired preoperative reserve related morbidity, prolonged increased use critical resource after RC. This has important health economic implications risk assessment, rationalisation potential therapeutic intervention therapy.