Evidence map›Paper›PMID 32518637›Full record

ArticlePerioperative medicine (London, England)2020

Why women are not small men: sex-related differences in perioperative cardiopulmonary exercise testing.

G Thomas, M A West, M Browning, G Minto, M Swart, K Richardson, L McGarrity, S Jack, M P W Grocott, D Z H Levett

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Article in Perioperative medicine (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

G Thomas *Department of Intensive Care, Spaarne Hospital, Haarlem, The Netherlands.ORCID 0000-0002-5506-8796
M A West *Academic Unit of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
M BrowningDepartment of Anaesthesia, Maidstone and Tunbridge Wells NHS Trust, Hermitage Lane, Maidstone, Kent, UK.
G MintoDirectorate of Anaesthesia, Derriford Hospital, 9th Floor Terence Lewis Building, Plymouth, UK.
M SwartDepartment of Anaesthesia and Critical Care Medicine, Torbay Hospital, Torquay, UK.
K RichardsonSTRAPH Research Group, School of Sport and Exercise Sciences, University of Kent, Canterbury, UK.
L McGarrityDepartment of Anaesthesia, University Hospital Crosshouse, Kilmarnock, East Ayrshire, Scotland, UK.
S JackIntegrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Sir Henry Wellcome Laboratories, Faculty of Medicine, University of Southampton, University Hospital Southampton NHS Foundation Trust, Mailpoint 810, Tremona Road, Southampton, SO16 6YD UK.
M P W Grocott *Anaesthesia Perioperative and Critical Care Research Group, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust/University of Southampton, Southampton, UK.
D Z H Levett *Anaesthesia Perioperative and Critical Care Research Group, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust/University of Southampton, Southampton, UK.

Funding

Department of Health PB-PG-0711-25093
6 · The paper itself

Abstract

backgroundThe use of preoperative cardiopulmonary exercise testing (CPET) to evaluate the risk of adverse perioperative outcomes is increasingly prevalent. CPET-derived information enables personalised perioperative care and enhances shared decision-making. Sex-related differences in physical fitness are reported in non-perioperative literature. However, little attention has been paid to sex-related differences in the context of perioperative CPET.

aimWe explored differences in the physical fitness variables reported in a recently published multi-centre study investigating CPET before colorectal surgery. We also report the inclusion rate of females in published perioperative CPET cohorts that are shaping guidelines and clinical practice.

methodsWe performed a post hoc analysis of the trial data of 703 patients who underwent CPET prior to major elective colorectal surgery. We also summarised the female inclusion rate in peer-reviewed published reports of perioperative CPET.

resultsFitness assessed using commonly used perioperative CPET variables-oxygen consumption at anaerobic threshold (AT) and peak exercise-was significantly higher in males than in females both before and after correction for body weight. In studies contributing to the development of perioperative CPET, 68.5% of the participants were male.

conclusionTo our knowledge, this is the first study to describe differences between males and females in CPET variables used in a perioperative setting. Furthermore, there is a substantial difference between the inclusion rates of males and females in this field. These findings require validation in larger cohorts and may have significant implications for both sexes in the application of CPET in the perioperative setting.

Indexed as

Cardiopulmonary exercise testingGender analysisPreoperative assessmentRisk predictionSex analysisSex characteristics

Identifiers

PMID32518637
PMCPMC7271469

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.