Validez de la velocidad estimada de onda de pulso aórtica medida durante la prueba de caminata de 6 minutos para predecir la capacidad anaeróbica antes de la cirugía mayor no cardiaca

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 ungergoing 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 higher 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.