Oxygen desaturation during 6-min walk test: implications for postoperative complications in non-small cell lung cancer patients with impaired lung function

Sumin Shin1, Sun Hye Shin2, Hyun Lee3, Jae Kyung Lee4, Genehee Lee4,5, Sunga Kong4,5, Danbee Kang5, Juhee Cho5,6,7, Jong Ho Cho1, Yong Soo Choi1, Jhingook Kim1, Jae Ill Zo1, Young Mog Shim1, and Hye Yun Park2 and Hong Kwan Kim1

1Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea, 3Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea 4Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Korea 5Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea 6Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 7epartment of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

Purpose : This study aimed to investigate the clinical implications of desaturation during the 6-min walk test (6MWT) for postoperative cardiopulmonary complications in non-small cell lung cancer (NSCLC) patients with moderately decreased lung function.

Methods : Between January 2010 and December 2019, 312 patients whose predicted postoperative value of forced expiratory volume in 1 second (ppoFEV1) or diffusing capacity of carbon monoxide (ppoDLco) were <60% while both were ≥ 30% and who had undergone lobectomy for NSCLC without induction treatment were included this study. Patients were classified into two groups based on the presence of oxygen desaturation (SpO2 <90%) during the 6MWT, and the prevalence and risk of cardiopulmonary complications were evaluated.

Results : Overall, 39 (12.5%) patients desaturated during the 6MWT. The prevalence of cardiopulmonary complications (48.7%, p = 0.007) and pulmonary complications (33.3%, p = 0.017) was significantly higher in patients who desaturated during the 6MWT than in those who did not. However, there was no significant difference in the incidence of postoperative cardiac complications between the two groups. In multivariable-adjusted analyses, the adjusted odds ratio for postoperative cardiopulmonary complications in patients who desaturated during the 6MWT was 2.34 (95% confidence interval = 1.16–4.75) compared to those who did not.

Conclusion : Oxygen desaturation during the 6MWT significantly increased the risk of post-lobectomy cardiopulmonary complications among lung cancer patients with moderately decreased lung function. Our study suggests that oxygen desaturation during the 6WMT could provide additional information when stratifying the postoperative surgical risks in NSCLC patients.

책임저자: 김홍관

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

발표자: Sumin Shin, E-mail : essennee@gmail.com