Using the 6-minute walk test to predict disability-free survival after major surgery

Using the 6-minute walk test to predict disability-free survival after major surgery

The 6-min walk test (6MWT) is a common means of functional assessment. Its relationship to disability-free survival (DFS) is uncertain. This sub-study of the Measurement of Exercise Tolerance for Surgery study had co-primary outcome measures: correlation of the preoperative 6MWT distance with 30 day...

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Veröffentlicht in:British journal of anaesthesia : BJA 2019-01, Vol.122 (1), p.111-119
Hauptverfasser: Shulman, M.A., Cuthbertson, B.H., Wijeysundera, D.N., Pearse, R.M., Thompson, B., Torres, E., Ambosta, A., Wallace, S., Farrington, C., Myles, P.S., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Wilde, C., MacCormick, A., Leslie, K., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Granton, J.T., Day, L., Pazmino-Canizares, J., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Thompson, H., McMillan, N., Back, G., Melo, M., Hillis, G.
Format: Artikel
Sprache:eng
Schlagworte:
Aged
assessment
cardiopulmonary exercise testing
Disability Evaluation
exercise test
Exercise Tolerance - physiology
Female
fitness testing
Humans
Male
Middle Aged
Oxygen Consumption - physiology
patient reported outcomes
postoperative outcome
Predictive Value of Tests
Preoperative Care - methods
Prognosis
Prospective Studies
risk
Risk Assessment - methods
ROC Curve
Surgical Procedures, Operative - rehabilitation
walk test
Walk Test - methods
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container_end_page 119
container_issue 1
container_start_page 111
container_title British journal of anaesthesia : BJA
container_volume 122
creator Shulman, M.A.
Cuthbertson, B.H.
Wijeysundera, D.N.
Pearse, R.M.
Thompson, B.
Torres, E.
Ambosta, A.
Wallace, S.
Farrington, C.
Myles, P.S.
Wallace, S.
Thompson, B.
Ellis, M.
Borg, B.
Kerridge, R.K.
Douglas, J.
Brannan, J.
Pretto, J.
Godsall, M.G.
Beauchamp, N.
Allen, S.
Kennedy, A.
Malherbe, J.
Ismail, H.
Riedel, B.
Melville, A.
Sivakumar, H.
Murmane, A.
Kenchington, K.
Gurunathan, U.
Stonell, C.
Brunello, K.
Steele, K.
Masel, P.
Dent, A.
Smith, E.
Bodger, A.
Abolfathi, M.
Sivalingam, P.
Hall, A.
Macklin, S.
Elliott, A.
Carrera, A.M.
Terblanche, N.C.S.
Pitt, S.
Wilde, C.
MacCormick, A.
Leslie, K.
Bramley, D.
Southcott, A.M.
Grant, J.
Taylor, H.
Bates, S.
Towns, M.
Tippett, A.
Marshall, F.
McCartney, C.J.L.
Choi, S.
Somascanthan, P.
Flores, K.
Beattie, W.S.
Karkouti, K.
Clarke, H.A.
Jerath, A.
McCluskey, S.A.
Wasowicz, M.
Granton, J.T.
Day, L.
Pazmino-Canizares, J.
Hagen, K.
Campbell, D.
Short, T.
Van Der Westhuizen, J.
Higgie, K.
Lindsay, H.
Jang, R.
Wong, C.
Mcallister, D.
Ali, M.
Kumar, J.
Waymouth, E.
Kim, C.
Lorimer, M.
Tai, J.
Miller, R.
Sara, R.
Collingwood, A.
Olliff, S.
Gabriel, S.
Houston, H.
Dalley, P.
Hurford, S.
Hunt, A.
Andrews, L.
Navarra, L.
Thompson, H.
McMillan, N.
Back, G.
Melo, M.
Hillis, G.
description The 6-min walk test (6MWT) is a common means of functional assessment. Its relationship to disability-free survival (DFS) is uncertain. This sub-study of the Measurement of Exercise Tolerance for Surgery study had co-primary outcome measures: correlation of the preoperative 6MWT distance with 30 day quality of recovery (15-item quality of recovery) and 12 month WHO Disability Assessment Schedule scores. The prognostic utility of the 6MWT and other risk assessment tools for 12 month DFS was assessed with logistic regression and receiver-operating-characteristic-curve analysis. Of 574 patients recruited, 567 (99%) completed the 6MWT. Twelve months after surgery, 16 (2.9%) patients had died and 444 (77%) had DFS. The 6MWT correlated weakly with 30 day 15-item quality of recovery (ρ=0.14; P=0.001) and 12 month WHO Disability Assessment Schedule (ρ=–0.23; P
doi_str_mv 10.1016/j.bja.2018.08.016
format Article
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Its relationship to disability-free survival (DFS) is uncertain. This sub-study of the Measurement of Exercise Tolerance for Surgery study had co-primary outcome measures: correlation of the preoperative 6MWT distance with 30 day quality of recovery (15-item quality of recovery) and 12 month WHO Disability Assessment Schedule scores. The prognostic utility of the 6MWT and other risk assessment tools for 12 month DFS was assessed with logistic regression and receiver-operating-characteristic-curve analysis. Of 574 patients recruited, 567 (99%) completed the 6MWT. Twelve months after surgery, 16 (2.9%) patients had died and 444 (77%) had DFS. The 6MWT correlated weakly with 30 day 15-item quality of recovery (ρ=0.14; P=0.001) and 12 month WHO Disability Assessment Schedule (ρ=–0.23; P&lt;0.0005) scores. When the cohort was split into 6MWT distance tertiles, the adjusted odds ratio of low vs high tertiles for DFS was 3.13 [95% confidence interval (CI): 1.54–6.35]. The only independent variable predictive of DFS was the Duke Activity Status Index (DASI) score (adjusted odds ratio: 1.06; P&lt;0.0005). The area under the receiver-operating-characteristic curve for DFS was 0.63 (95% CI: 0.57–0.70) for the 6MWT, 0.60 (95% CI: 0.53–0.67) for cardiopulmonary-exercise-testing-derived peak oxygen consumption, and 0.70 (95% CI: 0.64–0.76) for the DASI score. Of the risk assessment tools analysed, the DASI was the most predictive of DFS. The 6MWT was safe and comparable with cardiopulmonary exercise testing for all predictive assessments. Future research should aim to determine the optimal 6MWT distance thresholds for risk prediction.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1016/j.bja.2018.08.016</identifier><identifier>PMID: 30579389</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Aged ; assessment ; cardiopulmonary exercise testing ; Disability Evaluation ; exercise test ; Exercise Tolerance - physiology ; Female ; fitness testing ; Humans ; Male ; Middle Aged ; Oxygen Consumption - physiology ; patient reported outcomes ; postoperative outcome ; Predictive Value of Tests ; Preoperative Care - methods ; Prognosis ; Prospective Studies ; risk ; Risk Assessment - methods ; ROC Curve ; Surgical Procedures, Operative - rehabilitation ; walk test ; Walk Test - methods</subject><ispartof>British journal of anaesthesia : BJA, 2019-01, Vol.122 (1), p.111-119</ispartof><rights>2018 British Journal of Anaesthesia</rights><rights>Copyright © 2018 British Journal of Anaesthesia. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-edccd84bfde4d0fd1812f1f8cbf0de2e6db4bf6af2738fef4ff1de2eedd747b33</citedby><cites>FETCH-LOGICAL-c396t-edccd84bfde4d0fd1812f1f8cbf0de2e6db4bf6af2738fef4ff1de2eedd747b33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30579389$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shulman, M.A.</creatorcontrib><creatorcontrib>Cuthbertson, B.H.</creatorcontrib><creatorcontrib>Wijeysundera, D.N.</creatorcontrib><creatorcontrib>Pearse, R.M.</creatorcontrib><creatorcontrib>Thompson, B.</creatorcontrib><creatorcontrib>Torres, 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A.</creatorcontrib><creatorcontrib>Kenchington, K.</creatorcontrib><creatorcontrib>Gurunathan, U.</creatorcontrib><creatorcontrib>Stonell, C.</creatorcontrib><creatorcontrib>Brunello, K.</creatorcontrib><creatorcontrib>Steele, K.</creatorcontrib><creatorcontrib>Masel, P.</creatorcontrib><creatorcontrib>Dent, A.</creatorcontrib><creatorcontrib>Smith, E.</creatorcontrib><creatorcontrib>Bodger, A.</creatorcontrib><creatorcontrib>Abolfathi, M.</creatorcontrib><creatorcontrib>Sivalingam, P.</creatorcontrib><creatorcontrib>Hall, A.</creatorcontrib><creatorcontrib>Macklin, S.</creatorcontrib><creatorcontrib>Elliott, A.</creatorcontrib><creatorcontrib>Carrera, A.M.</creatorcontrib><creatorcontrib>Terblanche, N.C.S.</creatorcontrib><creatorcontrib>Pitt, S.</creatorcontrib><creatorcontrib>Wilde, C.</creatorcontrib><creatorcontrib>MacCormick, A.</creatorcontrib><creatorcontrib>Leslie, K.</creatorcontrib><creatorcontrib>Bramley, D.</creatorcontrib><creatorcontrib>Southcott, A.M.</creatorcontrib><creatorcontrib>Grant, J.</creatorcontrib><creatorcontrib>Taylor, H.</creatorcontrib><creatorcontrib>Bates, S.</creatorcontrib><creatorcontrib>Towns, M.</creatorcontrib><creatorcontrib>Tippett, A.</creatorcontrib><creatorcontrib>Marshall, F.</creatorcontrib><creatorcontrib>McCartney, C.J.L.</creatorcontrib><creatorcontrib>Choi, S.</creatorcontrib><creatorcontrib>Somascanthan, P.</creatorcontrib><creatorcontrib>Flores, K.</creatorcontrib><creatorcontrib>Beattie, W.S.</creatorcontrib><creatorcontrib>Karkouti, K.</creatorcontrib><creatorcontrib>Clarke, H.A.</creatorcontrib><creatorcontrib>Jerath, A.</creatorcontrib><creatorcontrib>McCluskey, S.A.</creatorcontrib><creatorcontrib>Wasowicz, M.</creatorcontrib><creatorcontrib>Granton, J.T.</creatorcontrib><creatorcontrib>Day, L.</creatorcontrib><creatorcontrib>Pazmino-Canizares, J.</creatorcontrib><creatorcontrib>Hagen, K.</creatorcontrib><creatorcontrib>Campbell, D.</creatorcontrib><creatorcontrib>Short, T.</creatorcontrib><creatorcontrib>Van Der Westhuizen, J.</creatorcontrib><creatorcontrib>Higgie, K.</creatorcontrib><creatorcontrib>Lindsay, H.</creatorcontrib><creatorcontrib>Jang, R.</creatorcontrib><creatorcontrib>Wong, C.</creatorcontrib><creatorcontrib>Mcallister, D.</creatorcontrib><creatorcontrib>Ali, M.</creatorcontrib><creatorcontrib>Kumar, J.</creatorcontrib><creatorcontrib>Waymouth, E.</creatorcontrib><creatorcontrib>Kim, C.</creatorcontrib><creatorcontrib>Lorimer, M.</creatorcontrib><creatorcontrib>Tai, J.</creatorcontrib><creatorcontrib>Miller, R.</creatorcontrib><creatorcontrib>Sara, R.</creatorcontrib><creatorcontrib>Collingwood, A.</creatorcontrib><creatorcontrib>Olliff, S.</creatorcontrib><creatorcontrib>Gabriel, S.</creatorcontrib><creatorcontrib>Houston, H.</creatorcontrib><creatorcontrib>Dalley, P.</creatorcontrib><creatorcontrib>Hurford, S.</creatorcontrib><creatorcontrib>Hunt, A.</creatorcontrib><creatorcontrib>Andrews, L.</creatorcontrib><creatorcontrib>Navarra, L.</creatorcontrib><creatorcontrib>Thompson, H.</creatorcontrib><creatorcontrib>McMillan, N.</creatorcontrib><creatorcontrib>Back, G.</creatorcontrib><creatorcontrib>Melo, M.</creatorcontrib><creatorcontrib>Hillis, G.</creatorcontrib><creatorcontrib>the Measurement of Exercise Tolerance for Surgery Study Investigators</creatorcontrib><creatorcontrib>Measurement of Exercise Tolerance for Surgery Study Investigators</creatorcontrib><title>Using the 6-minute walk test to predict disability-free survival after major surgery</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><description>The 6-min walk test (6MWT) is a common means of functional assessment. Its relationship to disability-free survival (DFS) is uncertain. This sub-study of the Measurement of Exercise Tolerance for Surgery study had co-primary outcome measures: correlation of the preoperative 6MWT distance with 30 day quality of recovery (15-item quality of recovery) and 12 month WHO Disability Assessment Schedule scores. The prognostic utility of the 6MWT and other risk assessment tools for 12 month DFS was assessed with logistic regression and receiver-operating-characteristic-curve analysis. Of 574 patients recruited, 567 (99%) completed the 6MWT. Twelve months after surgery, 16 (2.9%) patients had died and 444 (77%) had DFS. The 6MWT correlated weakly with 30 day 15-item quality of recovery (ρ=0.14; P=0.001) and 12 month WHO Disability Assessment Schedule (ρ=–0.23; P&lt;0.0005) scores. When the cohort was split into 6MWT distance tertiles, the adjusted odds ratio of low vs high tertiles for DFS was 3.13 [95% confidence interval (CI): 1.54–6.35]. The only independent variable predictive of DFS was the Duke Activity Status Index (DASI) score (adjusted odds ratio: 1.06; P&lt;0.0005). The area under the receiver-operating-characteristic curve for DFS was 0.63 (95% CI: 0.57–0.70) for the 6MWT, 0.60 (95% CI: 0.53–0.67) for cardiopulmonary-exercise-testing-derived peak oxygen consumption, and 0.70 (95% CI: 0.64–0.76) for the DASI score. Of the risk assessment tools analysed, the DASI was the most predictive of DFS. The 6MWT was safe and comparable with cardiopulmonary exercise testing for all predictive assessments. Future research should aim to determine the optimal 6MWT distance thresholds for risk prediction.</description><subject>Aged</subject><subject>assessment</subject><subject>cardiopulmonary exercise testing</subject><subject>Disability Evaluation</subject><subject>exercise test</subject><subject>Exercise Tolerance - physiology</subject><subject>Female</subject><subject>fitness testing</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Oxygen Consumption - physiology</subject><subject>patient reported outcomes</subject><subject>postoperative outcome</subject><subject>Predictive Value of Tests</subject><subject>Preoperative Care - methods</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>risk</subject><subject>Risk Assessment - methods</subject><subject>ROC Curve</subject><subject>Surgical Procedures, Operative - rehabilitation</subject><subject>walk test</subject><subject>Walk Test - 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Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201901</creationdate><title>Using the 6-minute walk test to predict disability-free survival after major surgery</title><author>Shulman, M.A. ; Cuthbertson, B.H. ; Wijeysundera, D.N. ; Pearse, R.M. ; Thompson, B. ; Torres, E. ; Ambosta, A. ; Wallace, S. ; Farrington, C. ; Myles, P.S. ; Wallace, S. ; Thompson, B. ; Ellis, M. ; Borg, B. ; Kerridge, R.K. ; Douglas, J. ; Brannan, J. ; Pretto, J. ; Godsall, M.G. ; Beauchamp, N. ; Allen, S. ; Kennedy, A. ; Malherbe, J. ; Ismail, H. ; Riedel, B. ; Melville, A. ; Sivakumar, H. ; Murmane, A. ; Kenchington, K. ; Gurunathan, U. ; Stonell, C. ; Brunello, K. ; Steele, K. ; Masel, P. ; Dent, A. ; Smith, E. ; Bodger, A. ; Abolfathi, M. ; Sivalingam, P. ; Hall, A. ; Macklin, S. ; Elliott, A. ; Carrera, A.M. ; Terblanche, N.C.S. ; Pitt, S. ; Wilde, C. ; MacCormick, A. ; Leslie, K. ; Bramley, D. ; Southcott, A.M. ; Grant, J. ; Taylor, H. ; Bates, S. ; Towns, M. ; Tippett, A. ; Marshall, F. ; McCartney, C.J.L. ; Choi, S. ; Somascanthan, P. ; Flores, K. ; Beattie, W.S. ; Karkouti, K. ; Clarke, H.A. ; Jerath, A. ; McCluskey, S.A. ; Wasowicz, M. ; Granton, J.T. ; Day, L. ; Pazmino-Canizares, J. ; Hagen, K. ; Campbell, D. ; Short, T. ; Van Der Westhuizen, J. ; Higgie, K. ; Lindsay, H. ; Jang, R. ; Wong, C. ; Mcallister, D. ; Ali, M. ; Kumar, J. ; Waymouth, E. ; Kim, C. ; Lorimer, M. ; Tai, J. ; Miller, R. ; Sara, R. ; Collingwood, A. ; Olliff, S. ; Gabriel, S. ; Houston, H. ; Dalley, P. ; Hurford, S. ; Hunt, A. ; Andrews, L. ; Navarra, L. ; Thompson, H. ; McMillan, N. ; Back, G. ; Melo, M. ; Hillis, G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-edccd84bfde4d0fd1812f1f8cbf0de2e6db4bf6af2738fef4ff1de2eedd747b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>assessment</topic><topic>cardiopulmonary exercise testing</topic><topic>Disability Evaluation</topic><topic>exercise test</topic><topic>Exercise Tolerance - physiology</topic><topic>Female</topic><topic>fitness testing</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Oxygen Consumption - physiology</topic><topic>patient reported outcomes</topic><topic>postoperative outcome</topic><topic>Predictive Value of Tests</topic><topic>Preoperative Care - methods</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>risk</topic><topic>Risk Assessment - methods</topic><topic>ROC Curve</topic><topic>Surgical Procedures, Operative - rehabilitation</topic><topic>walk test</topic><topic>Walk Test - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shulman, M.A.</creatorcontrib><creatorcontrib>Cuthbertson, B.H.</creatorcontrib><creatorcontrib>Wijeysundera, D.N.</creatorcontrib><creatorcontrib>Pearse, R.M.</creatorcontrib><creatorcontrib>Thompson, B.</creatorcontrib><creatorcontrib>Torres, E.</creatorcontrib><creatorcontrib>Ambosta, A.</creatorcontrib><creatorcontrib>Wallace, S.</creatorcontrib><creatorcontrib>Farrington, C.</creatorcontrib><creatorcontrib>Myles, P.S.</creatorcontrib><creatorcontrib>Wallace, S.</creatorcontrib><creatorcontrib>Thompson, B.</creatorcontrib><creatorcontrib>Ellis, M.</creatorcontrib><creatorcontrib>Borg, B.</creatorcontrib><creatorcontrib>Kerridge, R.K.</creatorcontrib><creatorcontrib>Douglas, J.</creatorcontrib><creatorcontrib>Brannan, J.</creatorcontrib><creatorcontrib>Pretto, J.</creatorcontrib><creatorcontrib>Godsall, 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R.</creatorcontrib><creatorcontrib>Sara, R.</creatorcontrib><creatorcontrib>Collingwood, A.</creatorcontrib><creatorcontrib>Olliff, S.</creatorcontrib><creatorcontrib>Gabriel, S.</creatorcontrib><creatorcontrib>Houston, H.</creatorcontrib><creatorcontrib>Dalley, P.</creatorcontrib><creatorcontrib>Hurford, S.</creatorcontrib><creatorcontrib>Hunt, A.</creatorcontrib><creatorcontrib>Andrews, L.</creatorcontrib><creatorcontrib>Navarra, L.</creatorcontrib><creatorcontrib>Thompson, H.</creatorcontrib><creatorcontrib>McMillan, N.</creatorcontrib><creatorcontrib>Back, G.</creatorcontrib><creatorcontrib>Melo, M.</creatorcontrib><creatorcontrib>Hillis, G.</creatorcontrib><creatorcontrib>the Measurement of Exercise Tolerance for Surgery Study Investigators</creatorcontrib><creatorcontrib>Measurement of Exercise Tolerance for Surgery Study Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shulman, M.A.</au><au>Cuthbertson, B.H.</au><au>Wijeysundera, D.N.</au><au>Pearse, R.M.</au><au>Thompson, B.</au><au>Torres, E.</au><au>Ambosta, A.</au><au>Wallace, S.</au><au>Farrington, C.</au><au>Myles, P.S.</au><au>Wallace, S.</au><au>Thompson, B.</au><au>Ellis, M.</au><au>Borg, B.</au><au>Kerridge, R.K.</au><au>Douglas, J.</au><au>Brannan, J.</au><au>Pretto, J.</au><au>Godsall, M.G.</au><au>Beauchamp, N.</au><au>Allen, S.</au><au>Kennedy, A.</au><au>Malherbe, J.</au><au>Ismail, H.</au><au>Riedel, B.</au><au>Melville, A.</au><au>Sivakumar, H.</au><au>Murmane, A.</au><au>Kenchington, K.</au><au>Gurunathan, U.</au><au>Stonell, C.</au><au>Brunello, K.</au><au>Steele, K.</au><au>Masel, P.</au><au>Dent, A.</au><au>Smith, E.</au><au>Bodger, A.</au><au>Abolfathi, M.</au><au>Sivalingam, P.</au><au>Hall, A.</au><au>Macklin, S.</au><au>Elliott, A.</au><au>Carrera, A.M.</au><au>Terblanche, N.C.S.</au><au>Pitt, S.</au><au>Wilde, C.</au><au>MacCormick, A.</au><au>Leslie, K.</au><au>Bramley, D.</au><au>Southcott, A.M.</au><au>Grant, J.</au><au>Taylor, H.</au><au>Bates, S.</au><au>Towns, M.</au><au>Tippett, A.</au><au>Marshall, F.</au><au>McCartney, C.J.L.</au><au>Choi, S.</au><au>Somascanthan, P.</au><au>Flores, K.</au><au>Beattie, W.S.</au><au>Karkouti, K.</au><au>Clarke, H.A.</au><au>Jerath, A.</au><au>McCluskey, S.A.</au><au>Wasowicz, M.</au><au>Granton, J.T.</au><au>Day, L.</au><au>Pazmino-Canizares, J.</au><au>Hagen, K.</au><au>Campbell, D.</au><au>Short, T.</au><au>Van Der Westhuizen, J.</au><au>Higgie, K.</au><au>Lindsay, H.</au><au>Jang, R.</au><au>Wong, C.</au><au>Mcallister, D.</au><au>Ali, M.</au><au>Kumar, J.</au><au>Waymouth, E.</au><au>Kim, C.</au><au>Lorimer, M.</au><au>Tai, J.</au><au>Miller, R.</au><au>Sara, R.</au><au>Collingwood, A.</au><au>Olliff, S.</au><au>Gabriel, S.</au><au>Houston, H.</au><au>Dalley, P.</au><au>Hurford, S.</au><au>Hunt, A.</au><au>Andrews, L.</au><au>Navarra, L.</au><au>Thompson, H.</au><au>McMillan, N.</au><au>Back, G.</au><au>Melo, M.</au><au>Hillis, G.</au><aucorp>the Measurement of Exercise Tolerance for Surgery Study Investigators</aucorp><aucorp>Measurement of Exercise Tolerance for Surgery Study Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Using the 6-minute walk test to predict disability-free survival after major surgery</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><addtitle>Br J Anaesth</addtitle><date>2019-01</date><risdate>2019</risdate><volume>122</volume><issue>1</issue><spage>111</spage><epage>119</epage><pages>111-119</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><abstract>The 6-min walk test (6MWT) is a common means of functional assessment. Its relationship to disability-free survival (DFS) is uncertain. This sub-study of the Measurement of Exercise Tolerance for Surgery study had co-primary outcome measures: correlation of the preoperative 6MWT distance with 30 day quality of recovery (15-item quality of recovery) and 12 month WHO Disability Assessment Schedule scores. The prognostic utility of the 6MWT and other risk assessment tools for 12 month DFS was assessed with logistic regression and receiver-operating-characteristic-curve analysis. Of 574 patients recruited, 567 (99%) completed the 6MWT. Twelve months after surgery, 16 (2.9%) patients had died and 444 (77%) had DFS. The 6MWT correlated weakly with 30 day 15-item quality of recovery (ρ=0.14; P=0.001) and 12 month WHO Disability Assessment Schedule (ρ=–0.23; P&lt;0.0005) scores. When the cohort was split into 6MWT distance tertiles, the adjusted odds ratio of low vs high tertiles for DFS was 3.13 [95% confidence interval (CI): 1.54–6.35]. The only independent variable predictive of DFS was the Duke Activity Status Index (DASI) score (adjusted odds ratio: 1.06; P&lt;0.0005). The area under the receiver-operating-characteristic curve for DFS was 0.63 (95% CI: 0.57–0.70) for the 6MWT, 0.60 (95% CI: 0.53–0.67) for cardiopulmonary-exercise-testing-derived peak oxygen consumption, and 0.70 (95% CI: 0.64–0.76) for the DASI score. Of the risk assessment tools analysed, the DASI was the most predictive of DFS. The 6MWT was safe and comparable with cardiopulmonary exercise testing for all predictive assessments. Future research should aim to determine the optimal 6MWT distance thresholds for risk prediction.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30579389</pmid><doi>10.1016/j.bja.2018.08.016</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection
subjects Aged
assessment
cardiopulmonary exercise testing
Disability Evaluation
exercise test
Exercise Tolerance - physiology
Female
fitness testing
Humans
Male
Middle Aged
Oxygen Consumption - physiology
patient reported outcomes
postoperative outcome
Predictive Value of Tests
Preoperative Care - methods
Prognosis
Prospective Studies
risk
Risk Assessment - methods
ROC Curve
Surgical Procedures, Operative - rehabilitation
walk test
Walk Test - methods
title Using the 6-minute walk test to predict disability-free survival after major surgery
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