Universal CPET and pancreatic surgery
Research type
Research Study
Full title
The effects of universal Cardiopulmonary Exercise Testing on perioperative planning and patient outcomes following elective Pancreatic Surgery: A retrospective cohort study.
IRAS ID
232681
Contact name
Chris Rollinson
Contact email
Sponsor organisation
Plymouth Hospitals NHS Trust
Duration of Study in the UK
5 years, 10 months, 30 days
Research summary
Cardiopulmonary exercise testing (CPET) is the gold standard method for measuring aerobic fitness. It is a non invasive but relatively resource heavy investigation.
Patients with reduced aerobic fitness are more at risk of dying, suffering complications and staying in hospital longer after major surgery.
The information from CPET is therefore used to help estimate risk, but it is also increasingly used to plan patients care; in particular which patients clinicians feel will benefit most from High Dependency care (HDU).
The assumption is that less fit patients are more likely to benefit from planned HDU care and should be prioritised for this limited resource.
Evidence for this approach is limited to a single study in colorectal surgery which showed survival benefit for patients whose care plan was informed by a CPET clinic.
Currently there is no evidence to support using CPET to aid perioperative planning in pancreatic surgery.
Prior to December 2013 in our hospital patients for pancreatic surgery were referred for CPET at surgical discretion (18% were referred). After December 2013 a policy change was instituted to universally refer for CPET.
We will explore if this change of practice has resulted in measured improvements in perioperative planning and patient outcomes for pancreatic surgery.
We will use a convenience sample of ~170 patients over a 3 year period from 01/01/2012 to 31/12/2014 to compare 2 cohorts: Cohort 1: CPET at discretion of the surgical team (n~100) and Cohort 2: universal referral for CPET (n~70)
We will also explore if any particular CPET variable is associated with risk of death and/or complications after pancreatic surgery for those patients who underwent CPET.REC name
East Midlands - Nottingham 2 Research Ethics Committee
REC reference
17/EM/0370
Date of REC Opinion
28 Sep 2017
REC opinion
Favourable Opinion