Six minute walk test for predicting postoperative pulmonary complications in high risk patients undergoing major abdominal elective surgery

The morbidity and mortality of patients are increased when postoperative pulmonary complications occurs. To prevent postoperative pulmonary complications, thorough preoperative cardiopulmonary functional assessment is required. To study was the preoperative 6-minute walk test (6MWT) and to determine the association of 6 minute walk distance with postoperative pulmonary complications (PPC) in patients undergoing elective abdominal surgery under general anaesthesia. The study was done in 60 adult high risk patients who were undergoing planned elective abdominal surgery under general anaesthesia. Patients having acute coronary disease, NYHA IV, unable to walk etc. were excluded. Preoperatively 6MWT was conducted according to the American Thoracic Society guidelines and patients were observed for PPC until they discharged from the hospital or died. Statistical analysis was done using SPSS software A total of 60 patients were recruited into the study. 6MWT was done completely in all cases without any complications. Out of the 60 patients, 32 patients had no PPC (group 1) and 28 patients had PPC (group 2). The 6MWD of group with PPCs was significantly less (344 ± 61.927 m) compared to the group without PPCs (442.28 ± 83.194 m, P value = 0.001). The cut off 6MWD obtained was 390 m, which correlated with longer duration of hospital stay and ICU stay (P = 0.001). A multiple regression analysis showed elderly, smoker and shorter 6-minute walk distance (6MWD) were the independent factors associated with PPC. 6MWT is a reliable predictor of postoperative pulmonary complications with a cutoff 6MWD of 390m in the high risk elderly patients posted for upper abdominal surgery patients.