Evidence map›Paper›PMID 40794670›Full record

ArticlePloS one2025

Exploring the association between socioeconomic status and cardiopulmonary exercise testing measures: A cohort study based on routinely collected data.

Donna Shrestha, Nicholas A Wisely, Theodoros M Bampouras, Daren A Subar, Cliff Shelton, Christopher J Gaffney

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing 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

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

6 authors.

Donna ShresthaLancaster Medical School, Lancaster University, Lancaster, United Kingdom.ORCID https://orcid.org/0000-0001-8711-3515
Nicholas A WiselyDepartment of Anaesthesia, Wythenshawe Hospital, Manchester, United Kingdom.ORCID https://orcid.org/0000-0002-5602-5755
Theodoros M BampourasSchool of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.ORCID https://orcid.org/0000-0002-8991-4655
Daren A SubarBlackburn Research Innovation Development Group in General Surgery (BRIDGES), Blackburn, United Kingdom.
Cliff SheltonLancaster Medical School, Lancaster University, Lancaster, United Kingdom.ORCID https://orcid.org/0000-0002-8438-398X
Christopher J GaffneyLancaster Medical School, Lancaster University, Lancaster, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiopulmonary exercise testing (CPET) provides objective measures of cardiorespiratory fitness and can support surgical risk stratification. As socioeconomic status is a factor known to influence patient health and outcomes, we analysed how CPET-derived measures vary across levels of socioeconomic status in patients being considered for elective surgery.

methodsA database of patients who underwent CPET between 2011 and 2024 was analysed. Measures including oxygen consumption (V̇O₂) at gas exchange threshold (GET), peak V̇O₂, and ventilatory equivalent for carbon dioxide (VE/V̇CO₂) were compared across socioeconomic deprivation quintiles. Multivariable linear and logistic regression models assessed the effects of age, sex, body mass index (BMI), Revised Cardiac Risk Index (RCRI), and deprivation quintiles on CPET measures. Hierarchical regression models incorporating the Indices of Deprivation (IoD) domains and Access to Healthy Assets and Hazards (AHAH) scores determined whether wider social determinants of health explained the variance in CPET measures.

resultsA total of 3344 patients (2476 male) were included, referred prior to procedures in vascular (2006), colorectal (650), upper GI (267), urology (205), and other (216) surgical specialties. Lower socioeconomic status was associated with younger age (p < 0.001), higher BMI (p = 0.022), higher smoking prevalence (p < 0.001), and RCRI ≥3 (p = 0.013). CPET measures were lower in the most deprived quintile (Q1) compared to the least (Q5): mean GET was 11.0 vs. 11.5 ml·kg-1·min-1 and peak V̇O2 was 14.8 vs. 16.3 ml·kg-1·min-1 (p < 0.05). Deprivation remained an independent predictor of lower GET and peak V̇O2, even after adjustment. Several IoD and AHAH domains explained small but significant variance in CPET measures.

conclusionPatients from more deprived areas exhibit risk factors for poor health and lower cardiorespiratory fitness as measured by CPET. These findings add to our understanding of socioeconomic disparities in physiological reserve among surgical patients and may support the need for more holistic approaches to peri-operative care.

Indexed as

Cardiorespiratory FitnessExercise TestSocial ClassSocial Determinants of HealthAgedAged, 80 and overAge FactorsBody Mass IndexFemaleHumansMaleMiddle AgedOxygen ConsumptionPreoperative CareProspective StudiesRisk Factors

Identifiers

PMID40794670
PMCPMC12342313

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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.