[Cardiorespiratory exercise tolerance tests: a preoperative surgical risks assessment in elderly patients]

Abstract

This study focuses on the most topical issue: non-cardiac surgery safety in elderly patients. According to different authors data, the mortality rate due to cardiovascular pathology %, and postoperative cardiac events incidence -from 2 to 4.4 %. For this reason we decided to conduct prospective risk assessment in the most dificult elderly patients group. Within the framework of this study we performed cardiorespiratory exercise testing (KAREN-test) in 17 elderly patients with various located colon cancer Concomitant diseases were: ischemic heart disease (12 patients), postinfarction cardiosclerosis (4 patients), arterial hypertension (12 patients), rhythm disturbances of varying degrees (11 patients), CHF (2 patients), and others. Patients were aged from 58 to 94 years. Subsequently, 14 of 17 patients were operated on, 11 of them underwent radical intervention. Cardiorespiratory exercise tolerance test was carried out according to moderate treadmill-test protocol for elderly patients developed in our clinic. Test duration was more than 4 minutes in all patients. During exercise stress peak, submaximal heart rate was observed in all patients, the peak oxygen consumption to a maximum current oxygen consumption ratio amounted to 94% on the average in a group, the oxygen consumption at the aerobic threshold level exceeded 11 mI/min/kg in all patients. There was no acute myocardial infarction and cerebrovascular events during perioperative period; the hospital mortality rate was 0%. Actual age by itself is not a contraindication for surgery. KAREN tests should become one of the key components for the assessment and treatment tactics choice.