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Assessment of operative risk of pneumonectomy.

Age, exercise tolerance, preoperative pulmonary function and associated diseases were correlated with postoperative mortality and morbidity in a group of 75 patients undergoing pneumonectomy over a ten-year period. No patient who completed the standard exercise tolerance test experienced cardiorespiratory mortality or morbidity subsequent to pneumonectomy, Eight of 14 patients who failed to complete the exercise tolerance test experienced serious cardiorespiratory complications. There were no significant differences between patients who had uncomplicated pneumonectomies and patients who had complications as regards other measurements of pulmonary function. Ability to complete the exercise tolerance test is associated with a low cardiorespiratory morbidity and mortality after pneumonectomy. Failure to complete the exercise tolerance test is a relative contraindication to pneumonectomy. The exercise tolerance test should be used whenever feasible in routine evaluation of the patient preparatory to pneumonectomy.