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Chest. 2001 Oct;120(4):1147-51.

Symptom-limited stair climbing as a predictor of postoperative cardiopulmonary complications after high-risk surgery.

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  • 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA 02135, USA.



Thoracotomy, sternotomy, and upper abdominal laparotomy are associated with high rate of postoperative cardiopulmonary complications (POCs). We hypothesized that symptom-limited stair climbing predicts POCs after high-risk surgery.


A prospective evaluation of 83 patients undergoing thoracotomy, sternotomy, and upper abdominal laparotomy surgery.


The 52 men and 31 women completed symptom-limited stair climbing. A separate investigator, blinded to the number of flights of stairs climbed, assessed 30-day actual outcomes for POCs, including pneumonia, atelectasis, mechanical ventilation for > 48 h, reintubation, myocardial infarction, congestive heart failure, arrhythmia, pulmonary embolus, and death within 30 days of surgery. The operations performed included 31 lobectomies, 6 wedge resections, 3 pneumonectomies, 3 substernal thymectomies, 1 substernal thyroidectomy, 23 colectomies, 3 laparotomies, 7 abdominal aortic aneurysm repairs, 5 esophagogastrectomies, and 1 nephrectomy.


POCs occurred in 21 of 83 patients (25%) overall, in 9 of 44 patients undergoing thoracotomy/sternotomy (20%), and in 12 of 39 patients undergoing upper abdominal laparotomy (31%). Of those unable to climb one flight of stairs, 89% developed a POC. No patient able to climb the maximum of seven flights of stairs had a POC. The inability to climb two flights of stairs was associated with a positive predictive value of 82% for the development of a POC. The number of days in the hospital postoperatively decreased with a patient's increased ability to climb stairs.


Symptom-limited stair climbing offers a simple, inexpensive means to predict POCs after high-risk surgery.

[PubMed - indexed for MEDLINE]
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