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CPET Risk Stratification — FRCA Final MCQ

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ModeratePreoperative AssessmentCPET Risk StratificationFRCA Final

A 72-year-old man (ASA III) is scheduled for a right hemicolectomy. Cardiopulmonary exercise testing shows a peak VO2 of 11 mL/kg/min and an anaerobic threshold of 8 mL/kg/min. What does this CPET result indicate?

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Correct answer: A — High perioperative risk – consider HDU/ICU bed post-operatively

CPET results stratify perioperative risk: AT <11 mL/kg/min and peak VO2 <15 mL/kg/min indicate high risk for major abdominal surgery, with increased postoperative complications and mortality. These patients benefit from enhanced perioperative care including planned HDU/ICU admission, goal-directed fluid therapy, and prehabilitation if time allows. An AT <8 mL/kg/min suggests very high risk but does not absolutely contraindicate surgery – a risk-benefit discussion with the patient is essential.

Reference: RCOA – 2023 – CPET in preoperative assessment; NICE – 2020 – Perioperative care