@article{3954d9ecfa5d4f81b01c0230006bacf7,
title = "Using the 6-minute walk test to predict disability-free survival after major surgery",
abstract = "BACKGROUND: The 6-min walk test (6MWT) is a common means of functional assessment. Its relationship to disability-free survival (DFS) is uncertain.METHODS: 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.RESULTS: 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<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<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.CONCLUSIONS: 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.",
keywords = "assessment, cardiopulmonary exercise testing, exercise test, fitness testing, patient reported outcomes, postoperative outcome, risk, walk test",
author = "{the Measurement of Exercise Tolerance for Surgery Study Investigators} and Shulman, {M. A.} and Cuthbertson, {B. H.} and Wijeysundera, {D. N.} and Pearse, {R. M.} and B. Thompson and E. Torres and A. Ambosta and S. Wallace and C. Farrington and Myles, {P. S.} and M. Ellis and B. Borg and Kerridge, {R. K.} and J. Douglas and J. Brannan and J. Pretto and Godsall, {M. G.} and N. Beauchamp and S. Allen and A. Kennedy and E. Wright and J. Malherbe and H. Ismail and B. Riedel and A. Melville and H. Sivakumar and A. Murmane and K. Kenchington and U. Gurunathan and C. Stonell and K. Brunello and K. Steele and O. Tronstad and P. Masel and A. Dent and E. Smith and A. Bodger and M. Abolfathi and P. Sivalingam and A. Hall and T. Painter and S. Macklin and A. Elliott and Carrera, {A. M.} and Terblanche, {N. C.S.} and S. Pitt and J. Samuels and C. Wilde and A. MacCormick and K. Leslie and D. Bramley and Southcott, {A. M.} and J. Grant and H. Taylor and S. Bates and M. Towns and A. Tippett and F. Marshall and McCartney, {C. J.L.} and S. Choi and P. Somascanthan and K. Flores and Beattie, {W. S.} and K. Karkouti and Clarke, {H. A.} and A. Jerath and McCluskey, {S. A.} and M. Wasowicz and Granton, {J. T.} and L. Day and J. Pazmino-Canizares and K. Hagen and D. Campbell and T. Short and {Van Der Westhuizen}, J. and K. Higgie and H. Lindsay and R. Jang and C. Wong and D. Mcallister and M. Ali and J. Kumar and E. Waymouth and C. Kim and J. Dimech and M. Lorimer and J. Tai and R. Miller and R. Sara and A. Collingwood and S. Olliff and S. Gabriel and H. Houston and P. Dalley and S. Hurford and L. Andrews and L. Navarra and A. Jason-Smith and N. McMillan and G. Back and M. Melo and M. Mamdani and G. Hillis and Wijeysundera, {H. C.} and H. Thompson and A. Hunt",
year = "2019",
month = jan,
doi = "10.1016/j.bja.2018.08.016",
language = "English",
volume = "122",
pages = "111--119",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "1",
}