Reviewing postoperative cardiorespiratory morbidity in patients assessed by CPET: a 10-year experience

<bold>Introduction:</bold> Cardiopulmonary Exercise Test (CPET) is recommended in preoperative risk stratification of patients with previously documented functional limitation set to undergo lung resection, as it provides a good estimate of the cardiopulmonary reserve. <bold>Methods:</bold> Retrospective observational study conducted with data obtained from clinical records of patients preoperatively assessed by CPET between January 2013 and December 2023 in a Portuguese hospital. Cardiorespiratory morbidity in the 30 days following surgery was noted. <bold>Results:</bold> 55 patients were included. They were mostly male (61.8%), with a mean age of 64.4 years. 34 patients were still smokers (61.8%) and the most common comorbidity was COPD (63.6%). Approximately half the sample was overweight. Most patients underwent Lobectomy (56.4%). 19 patients (34.5%) experienced at least one postoperative cardiorespiratory complication and one patient died. The most frequent complications were respiratory tract infections (n=15) and dysrhythmia (n=6). Patients with postoperative morbidity were older and most likely smokers. The absolute and predicted VO2Max were inferior in patients with complications, though not significantly (p 0.431 and p 0.085, respectively). Even so,VO2Max was significantly lower in patients with infectious complications (p 0.039). No significant association was noted between postoperative morbidity and type of lung resection (p 0.054). <bold>Conclusion:</bold> We observed a low mortality rate in our sample, and morbidity comparable to previously reported studies. The critical interpretation of stress response patterns in CPET may illustrate the postoperative morbidity risk and allow the planning of better prehabilitation and rehabilitation programmes.