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

Background: Peak oxygen uptake (VO2 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 estima...

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Main Authors: Nicholas Tetlow, Philip Devendra, James Waiting, Maria Aresu, Abena Glover, Martin Rooms, Shaman Jhanji, Don Milliken
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:BJA Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S277260962500019X
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Summary:Background: Peak oxygen uptake (VO2 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 VO2 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 VO2 peak and CPET-measured VO2 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 VO2 peak and CPET-measured VO2 peak: Pearson r=0.111 (95% confidence interval −0.242 to 0.437), R2=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 VO2 peak and CPET-measured VO2 peak in the hepato-pancreato-biliary or gastro-oesophageal subgroup or between Seismofit®-estimated VO2 peak and commonly reported CPET variables. Conclusions: There was no evidence of linear association between Seismofit®-estimated VO2 peak and objectively measured VO2 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 VO2 peak with a high degree of bias. Clinical trial registration: NCT05831488.
ISSN:2772-6096