评估Seismofit®作为肝-胰-胆道、结直肠癌和胃-食管癌患者术前最大耗氧量估计的准确性

BJA open Pub Date : 2025-04-08 DOI:10.1016/j.bjao.2025.100395

Nicholas Tetlow , Philip Devendra , James Waiting , Maria Aresu , Abena Glover , Martin Rooms , Shaman Jhanji , Don Milliken

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引用次数: 0

摘要

背景：在心肺运动试验（CPET）期间测量的峰值摄氧量（VO2峰值）通常用于客观评估健康和告知风险分层。术前CPET并不总是普遍可用。Seismofit®为估计VO2峰值提供了一种无创、非运动的替代方法，尽管它尚未在等待重大腹部癌症手术的患者中得到验证。方法对肝-胰-胆道癌、结直肠癌或胃-食管癌患者进行术前评估的前瞻性单中心盲法观察研究。患者在常规CPET前接受Seismofit®评估。主要结局是Seismofit®估计的VO2峰值与cpet测量的VO2峰值之间的关系。次要结局探讨了Seismofit®和CPET之间的关系(1)偏倚和一致性限制；（ii）外科亚组；（iii）通常报告的CPET变量；（iv）患者接受程度。33名参与者(年龄中位数[四分位数间距]:67岁[58-75岁]；20名（61%）男性完成了CPET和Seismofit®。Seismofit®估计的VO2峰值与cpet测量的VO2峰值之间没有发现线性关联：Pearson r=0.111(95%可信区间- 0.242至0.437),R2=0.012， P=0.539。与CPET相比，Seismofit®具有较大的偏差（标准偏差）12.8 (8.8)；95%一致性限（- 4.5至30.0）。在肝-胰-胆或胃-食管亚组中，Seismofit®估计的VO2峰值与CPET测量的VO2峰值之间没有关联，Seismofit®估计的VO2峰值与通常报道的CPET变量之间也没有关联。结论：在接受重大腹部肿瘤手术评估的患者中，Seismofit®估计的VO2峰值与CPET客观测量的VO2峰值之间没有线性关联。这一发现在所有亚组和探索性分析中是一致的。Seismofit®倾向于高估VO2峰值，偏差程度很高。临床试验注册号nct05831488。

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Assessing the accuracy of Seismofit® as an estimate of preoperative maximal oxygen consumption in patients with hepato-pancreato-biliary, colorectal, and gastro-oesophageal cancer

Background

Peak oxygen uptake (VO₂ peak) measured during cardiopulmonary exercise testing (CPET) is commonly used to objectively assess fitness and inform risk stratification. Preoperative CPET is not always universally available. Seismofit® offers a noninvasive, non-exercise alternative for estimating VO₂ peak, though it has not been validated in patients awaiting major abdominal cancer surgery.

Methods

Prospective single-centre blinded observational study in patients with hepato-pancreato-biliary, colorectal, or gastro-oesophageal cancer undergoing preoperative assessment. Patients underwent Seismofit® assessment before routine CPET. Primary outcome was the relationship between Seismofit®-estimated VO₂ peak and CPET-measured VO₂ peak. Secondary outcomes explored the relationship between Seismofit® and CPET for (i) bias and agreement limits; (ii) surgical subgroup; (iii) commonly reported CPET variables; (iv) patient acceptance.

Results

Thirty-three participants (median [interquartile range] age: 67 yr [58–75 yr]; 20 [61%] males) completed both CPET and Seismofit®. No linear association was found between Seismofit®-estimated VO₂ peak and CPET-measured VO₂ peak: Pearson r=0.111 (95% confidence interval −0.242 to 0.437), R²=0.012, P=0.539. Compared with CPET, Seismofit® demonstrated a large bias (standard deviation) 12.8 (8.8); 95% limits of agreement (−4.5 to 30.0). No association existed between Seismofit®-estimated VO₂ peak and CPET-measured VO₂ peak in the hepato-pancreato-biliary or gastro-oesophageal subgroup or between Seismofit®-estimated VO₂ peak and commonly reported CPET variables.

Conclusions

There was no evidence of linear association between Seismofit®-estimated VO₂ peak and objectively measured VO₂ peak by CPET in patients undergoing assessment for major abdominal cancer surgery. This finding was consistent across all subgroup and exploratory analyses. Seismofit® tended to overestimate VO₂ peak with a high degree of bias.