Grant: Project Grant

After surgery, 1 in 6 patients have complications. These problems include infections, bleeding and breathing difficulties. A good understanding of patients' fitness before surgery is very helpful because poor fitness can often lead to complications. Doctors usually estimate patients' fitness by asking them about usual activities such walking or climbing stairs. However, we recently finished a study of 1401 patients and found major problems with how doctors ask these questions. Doctors' questions could not identify patients who were more likely to have complications. We also found that a special exercise test, called CPET, was better. CPET did identify patients who had complications, but it is not practical. The reason is that CPET needs expensive equipment not found at many Canadian hospitals. We thus need a better solution. A very good option is the 6-minute walk test or 6MWT. This simple test measures the distance someone can walk over 6 minutes on flat ground. Some small studies suggest that the 6MWT may identify patients who have complications after surgery. However, we still need a much higher-quality study to be really sure that 6MWT can identify patients who have complications. We also need to see if the 6MWT is better than simpler options, such as a short questionnaire called DASI, a blood test called NT pro-BNP, and a simple physical test called the hand grip test. Therefore, we want to conduct the FAST Walk study of 1672 patients at 14 Canadian hospitals. Each patient will complete the 6MWT, DASI, NT pro-BNP test and hand grip test before surgery. We will follow them for 90 days after surgery to compare the tests for identifying people at risk for complications. By helping to better identify high-risk patients before surgery, our study will improve their care and thus help prevent complications. It will also make sure that specialized (and expensive) care is used in patients who need it. Thus, our study will help patients having surgery across Canada.