336 Cardiopulmonary Fitness and CR-POSSUM in One-Year Outcomes of Colorectal Patients

Aim

Colorectal surgery can be a high-risk surgery. Risk stratification takes the form of calculation tools, like ColoRectal Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (CR-POSSUM), and measurement of cardiopulmonary fitness using exercise test(CPET). Literature search on Pubmed and Science Direct did not show any studies have reviewed correlation between both tests and postoperative outcomes of patients undergoing colorectal surgery. Hence, we aim to assess correlation of CR-POSSUM and CPET using postoperative morbidity as primary outcome.

Method

All patients with stage I-IV CRC who underwent CPET testing between January 2013-June 2021 were collected and followed-up for 30days. Major postoperative complications were classified using Clavien-Dindo Classification≥Grade 3. Anaerobic threshold (AT) and VO2Max were used as markers of cardiopulmonary fitness on CPET.

Results

In total, 160 individuals with both CR-POSSUM and CPET were included,64% were male,115 underwent surgery. Median age was 77.2(±8.0). Mean CR-POSSUM operative severity, physiology score and predicted mortality were 7.5(7-9), 11.7(6-18) and 7.0(0.7-28.4) respectively. Mean AT was 9.9(±2.27) kg/ml/min and VO2Max was 74.4(±15.2)%. These variables did not show normal distribution(p-<0.05).

AT was correlated with VO2Max(p = 0.03), but not CR-POSSUM. VO2Max was correlated with CR-POSSUM physiology score(p = 0.002) and CR-POSSUM predicted mortality(p = 0.003). Fifteen (13%) patients experienced major post-operative complications. There was no correlation between presence of severe complications and AT, VO2Max or CR-POSSUM(p>0.05).

Conclusions

Some CPET variables correlates with CR-POSSUM physiology score and predicted mortality. Low level of cardiorespiratory fitness did not predict major postoperative complication.