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Gait speed predicted elderly at risk for cardiac surgery-related mortality, morbidity
Afilalo J. J Am Coll Cardiol. 2010;56:1668-1676.
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New findings from a multicenter prospective cohort study of elderly patients have shown that measuring gait speed is a simple yet effective tool for determining those at higher risk for mortality and major morbidity after cardiac surgery.
The cohort consisted of 131 patients (66% men) with a mean age of 75.8 ± 4.4 years. Eligible patients were given a 5-minute gait speed test to determine whether they had a slow (5-meter walk in 6 seconds or longer) or normal (5 meters in less than 6 seconds) speed and asked to complete a questionnaire. Cardiac surgery was later performed at four university-affiliated tertiary care hospitals between February 2008 and June 2009.
Before cardiac surgery, 60 patients (46%) were classified as being slow walkers, who were most often women (43% vs. 25%, P=.03) and diabetics (50% vs. 28%, P=.01). The primary composite endpoint of mortality or major morbidity post-cardiac surgery was reported in 30 patients (23%). Patients with a slow gait speed had an OR of 3.05 (95% CI, 1.23-7.54) for the composite endpoint after adjusting for The Society of Thoracic Surgeons risk score.
These results, the researchers wrote, may be generalized to other centers because of the multicenter design and nonrestrictive inclusion criteria intended to reflect real-world practice.
“Gait speed has the advantage of being applicable in daily practice with minimal investment,” they said. “Future efforts should be directed toward validating the optimal cutoff for slow gait speed, implementing gait speed in existing risk models, and developing targeted interventions for vulnerable elderly patients with slow gait speed.”
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