Validity of estimated aortic pulse wave velocity measured during the 6-min walk test to predict anaerobic fitness before major non-cardiac surgery.

J Ripollés-Melchor, M I Monge García, A Ruiz-Escobar, E Sáez-Ruiz, B Algar-Yañez, A Abad-Motos, A Abad-Gurumeta
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Abstract

Background: This study aimed to assess the efficacy of estimated preoperative aortic pulse wave velocity (AoPWV) to discriminate between low and high 6 min walk test (6MWT) distance in patients awaiting major non-cardiac surgery.

Methods: Prospective observational study in 133 patients undergoing non cardiac surgery. AoPWV and the distance walked during a 6MWT were assessed. Receiver operating characteristic (ROC) curve analysis was used to determine two different AoPWV cut-points for predicting a distance of 427 m in the 6MWT. We also calculated lower and upper AoPWV cut-points (probability ≥ 0.75) for predicting a distance of < 427 m, ≥427 m, and also 563 m in the 6MWT.

Results: The ROC curve analysis for the < 427 m distance revealed an area under the curve (AUC) of 0.68 (95% confidence interval 0.56-0.79) and an AUC of 0.72 (95% confidence interval 0.61-0.83) for >563 m. Patients with AoPWV > 10.97 m/s should be considered high risk, while those with <9.42 m/s can be considered low risk.

Conclusions: AoPWV is a simple, non-invasive, useful clinical tool for identifying and stratifying patients awaiting major non-cardiac surgery. In situations of clinical uncertainty, additional measures should be taken to assess the risk.

在 6 分钟步行测试中测量的主动脉脉搏波速度估计值在预测非心脏大手术前的有氧体能方面的有效性。
背景:本研究旨在评估估计的术前主动脉脉搏波速度(AoPWV)在区分等待接受非心脏大手术的患者6分钟步行测试(6MWT)距离过短和过长方面的有效性:方法:对 133 名接受非心脏手术的患者进行前瞻性观察研究。方法:对 133 名接受非心脏手术的患者进行了前瞻性观察研究,评估了患者的 AoPWV 和 6MWT 步行距离。使用接收者操作特征曲线(ROC)分析确定了两个不同的 AoPWV 切点,用于预测 6MWT 步行 427 米的距离。我们还计算了预测 6MWT 距离< 427 米、≥ 427 米和 563 米的较低和较高 AoPWV 切点(概率≥ 0.75):对<427米距离的ROC曲线分析显示,曲线下面积(AUC)为0.68(95%置信区间为0.56-0.79),对>563米距离的曲线下面积(AUC)为0.72(95%置信区间为0.61-0.83)。AoPWV>10.97米/秒的患者应被视为高风险,而AoPWV<9.42米/秒的患者可被视为低风险:AoPWV是一种简单、无创、有用的临床工具,可用于识别和分层等待非心脏大手术的患者。在临床不确定的情况下,应采取其他措施来评估风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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