Work

Assessing the accuracy of Seismofit® as an estimate of preoperative maximal oxygen consumption in patients with hepato-pancreato-biliary, colorectal, and gastro-oesophageal cancer

Year: 2025

Type: article

Abstract: Background Peak oxygen uptake (VO 2 peak) measured during cardiopulmonary exercise testing (CPET) is commonly used to objectively assess fitness and inform risk stratification. Preoperative CPET is not always universally available. Seismofit® offers a noninvasive, non-exercise alternative for estimating VO 2 peak, though it has not been validated in patients awaiting major abdominal cancer surgery. Methods Prospective single-centre blinded observational study in patients with hepato-pancreato-biliary, colorectal, or gastro-oesophageal cancer undergoing preoperative assessment. Patients underwent Seismofit® assessment before routine CPET. Primary outcome was the relationship between Seismofit ®- estimated VO 2 peak and CPET-measured VO 2 peak. Secondary outcomes explored the relationship between Seismofit® and CPET for (i) bias and agreement limits; (ii) surgical subgroup; (iii) commonly reported CPET variables; (iv) patient acceptance. Results Thirty-three participants (median [interquartile range] age: 67 yr [58–75 yr]; 20 [61%] males) completed both CPET and Seismofit®. No linear association was found between Seismofit ®- estimated VO 2 peak and CPET-measured VO 2 peak: Pearson r =0.111 (95% confidence interval −0.242 to 0.437), R 2 =0.012, P =0.539. Compared with CPET, Seismofit® demonstrated a large bias (standard deviation) 12.8 (8.8); 95% limits of agreement (−4.5 to 30.0). No association existed between Seismofit ®- estimated VO 2 peak and CPET-measured VO 2 peak in the hepato-pancreato-biliary or gastro-oesophageal subgroup or between Seismofit®-estimated VO 2 peak and commonly reported CPET variables. Conclusions There was no evidence of linear association between Seismofit®-estimated VO 2 peak and objectively measured VO 2 peak by CPET in patients undergoing assessment for major abdominal cancer surgery. This finding was consistent across all subgroup and exploratory analyses. Seismofit® tended to overestimate VO 2 peak with a high degree of bias. Clinical trial registration NCT05831488.

Source: BJA Open

DOI: 10.1016/j.bjao.2025.100395