Preoperative Assessment of a Patient’s Functional Status. Current State of the Problem

K.А. Tsygankov, A.V. Shсhegolev, R.E. Lahin

Federal State Budgetary Educational Military Institution of Higher Professional Education Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation

For correspondence: Tsygankov Kirill Alekseevich — adjunct, Federal State Budgetary Educational Military Institution of Higher Professional Education Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation, the Department of Anesthesiology and Intensive Care, St. Petersburg; e-mail: doctorcygankov@mail.ru

For citation: Tsygankov KА, Shchegolev AV, Lahin RE. Preoperative Assessment of a Patient’s Functional Status. Current State of the Problem. Intensive Care Herald. 2017;3:35–41.


The article is devoted to the significant and actively discussed problem of the prognosis of the complications development in non-cardiac surgery. Despite the progress and the increasing use of intraoperative monitoring, the improvement of the anesthesia methods and the success of clinical pharmacology, the importance of surgical and drug aggression in the manifestation of mechanisms of surgical stress remains. In these conditions, the role of anesthesiologists in providing patient safety during surgical intervention and anesthesia becomes even more important, as well as in the early postoperative period. It should be noted that, despite a large number of publications concerning patients’ functional status assessment and the prognosis of complications, the data about informative methods of preoperative prediction of complications during surgery and anesthesia is almost absent. At the same time, at the current level of science and anesthesiology and resuscitation practice development, the methods for determining the risk and predicting complications should be maximally objectified. All of the circumstances above determine the urgency of searching for opportunities to improve anesthesia safety with the help of objective prediction of the complications development.

Keywords: preoperative examination, operational-anesthesia risk, cardiovascular complications, functional exercise tests, anaerobic threshold, cardiorespiratory stress testing

Received: 28.06.2017


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Рossibility Prediction of Critical Incident during Elective Surgery in Abdominal Surgery

K.A. Tsygankov, A.V. Shchegolev, D.A. Averianov, S.V. Bokatyuk

FGBVOU VPO «Military-Medical Academy n.a. C.M. Kirov» MO RF, St. Petersburg

For citation: Tsygankov KA, Shchegolev AV, Averianov DA, Bokatyuk SV. Critical Incident Prediction Рossibility in Elective Abdominal Surgery. Intensive Care Herald. 2016;2:80–84. 


Тhe aim of the study. This article describes a method of prediction of critical incidents. Materials and methods. In the study 52 patients were included, mean age was 61 (55; 68) years. The physical status classification ASA II 39 patients (75 %), ASA III — 13 patients (25 %). In the preoperative period, patients performed a six-minute test and a questionnaire filled daily activities of Duke. The next day performed cardiorespiratory exercise testing. To perform this test using «Ultima CPX» company Medical Graphics (USA) system. On stage, the anesthesia monitoring of critical incidents and use of statistical methods is determined which of the indexes has the highest predictive value. Results. Using logistic regression revealed the possibility of prediction of critical incidents using the anaerobic threshold and the six-minute test. In constructing the ROC-curve is obtained that the low sensitivity and specificity of the six-minute test does not allow the use of this method for predicting the development of critical incidents, in contrast, the anaerobic threshold testified to the high probability of critical incidents. The area of the curve was 0.991. The significance of the area (p < 0.05) showed the usefulness of anaerobic threshold to determine the likelihood of critical incidents. From the curve coordinate table we found that the threshold sensitivity of 100 % and specificity of 95 % is the value of 10.85 ml/kg/min. Given the data rate of the critical analyzed incidents resulting revealed that patients with less anaerobic threshold 10.85 ml/kg/min developed 36 (85.7 %) of the critical stages of anesthesia incidents, and in patients with more anaerobic threshold 10.85 ml/kg/min, only 6 (14.2 %). Conclusions. These results confirm the possibility of prediction of critical incidents in the preoperative period with the help of the anaerobic threshold.

Keywords: preoperative examination, functional status, cardiorespiratory exercise test, anaerobic threshold, critical incidents

Received: 18.04.2016


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