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Timed Stair Climbing Is the Single Strongest Predictor of Perioperative Complications in Patients Undergoing Abdominal Surgery  Sushanth Reddy, MD, FACS,

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Presentation on theme: "Timed Stair Climbing Is the Single Strongest Predictor of Perioperative Complications in Patients Undergoing Abdominal Surgery  Sushanth Reddy, MD, FACS,"— Presentation transcript:

1 Timed Stair Climbing Is the Single Strongest Predictor of Perioperative Complications in Patients Undergoing Abdominal Surgery  Sushanth Reddy, MD, FACS, Carlo M. Contreras, MD, FACS, Brandon Singletary, MPH, T. Miller Bradford, Mary G. Waldrop, Andrew H. Mims, W. Andrew Smedley, Jacob A. Swords, Thomas N. Wang, MD, PhD, FACS, Martin J. Heslin, MD, MSHA, FACS  Journal of the American College of Surgeons  Volume 222, Issue 4, Pages (April 2016) DOI: /j.jamcollsurg Copyright © 2016 American College of Surgeons Terms and Conditions

2 Figure 1 Stair climbing and changes in vital signs (VS). Changes in patients' heart rate (HR) and mean arterial pressure (MAP) were calculated as a function of the stair climbing time. Patients who were slower climbing stairs had a greater deviation in their vital signs (Wilcoxon rank sum test, p < ). Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg ) Copyright © 2016 American College of Surgeons Terms and Conditions

3 Figure 2 Stair climbing time and surgical complications. Patients who were slower to climb stairs had an increased complication rate (Wilcoxon rank sum test, p < ). Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg ) Copyright © 2016 American College of Surgeons Terms and Conditions

4 Figure 3 Receiver operator characteristic (ROC) curves. The area under the curve is compared with the null hypothesis (diagonal line) where the area is 0.5. The stair climbing time is in blue and the American College of Surgeons (ACS) NSQIP curve is in red. For the stair climbing time and the ACS NSQIP calculator, the area under the curve is (95% CI, – ) and (95% CI, – ), respectively. The difference in the curves is statistically significant (p < ). Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg ) Copyright © 2016 American College of Surgeons Terms and Conditions

5 Figure 4 Stair climbing and hospital length of stay. The deviation from predicted length of stay was calculated by subtracting the predicted length of stay from the actual length of stay. Patients who were slower climbing stairs had a relative increase length of stay (Wilcoxon rank sum test, p = 0.033). Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg ) Copyright © 2016 American College of Surgeons Terms and Conditions

6 Figure 5 Stair climbing time and complications for colorectal surgery patients. Slower patients had an increased complication rate (Wilcoxon rank sum test, p < ). Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg ) Copyright © 2016 American College of Surgeons Terms and Conditions

7 Figure 6 Stair climbing and length of stay for colorectal surgery patients. A stepwise trend is observed as patients with increased stair climbing time had a greater deviation from their expected length of stay, but this did not reach statistical significance (p = 0.36). Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg ) Copyright © 2016 American College of Surgeons Terms and Conditions

8 Figure 7 Receiver operator characteristic (ROC) curves for colorectal surgery patients. The stair climbing time is in blue and the American College of Surgeons (ACS) NSQIP curve is in red. For the stair climbing time and the ACS NSQIP calculator the area under the curve is (95% CI, – ) and (95% CI, – ), respectively. The difference in the curves is statistically significant (p = 0.006). Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg ) Copyright © 2016 American College of Surgeons Terms and Conditions

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