Gait speed and 1-year mortality following cardiac surgery: A landmark analysis from the society of thoracic surgeons adult cardiac surgery database

Jonathan Afilalo, Abhinav Sharma, Shuaiqi Zhang, J. Matthew Brennan, Fred H. Edwards, Michael J. Mack, James B. McClurken, Joseph C. Cleveland, Peter K. Smith, David M. Shahian, Eric D. Peterson, Karen P. Alexander

Research output: Contribution to journalArticlepeer-review

Abstract

Background-—In older adults undergoing cardiac surgery, prediction of downstream risk is critical. Our objective was to determine the association of 5-m gait speed with 1-year mortality and repeat hospitalization following cardiac surgery. Methods and Results-—In this prospective cohort of patients undergoing cardiac surgery at centers participating in the Society of Thoracic Surgeons Database with gait speed recorded, we examined all-cause mortality using a landmark analysis at 0 to 30, 30 to 365, and >365 days, as well as repeat hospitalization. The cohort consisted of 8287 patients (median age, 74 years; 32% females). At 1 year, survival was 90% in the slow (<0.83 m/s), 95% in the middle (0.83–1.00 m/s), and 97% in the fast (>1.00 m/s) gait speed tertiles, and risk of hospitalization was 45%, 33%, and 27%, respectively (both P<0.0001). After adjustment, gait speed remained predictive of mortality (hazard ratio, 2.16 per 0.1-m/s decrease in gait speed; 95% confidence interval, 1.59–2.93) and rehospitalization (hazard ratio, 1.71 per 0.1-m/s decrease in gait speed; 95% confidence interval, 1.45–2.0). In a landmark analysis, the effect of slow gait speed on mortality was most marked from 30 to 365 days after surgery, where each decline in 0.1 m/s of gait speed conferred a 2-fold increased risk of mortality. Conclusions-—Gait speed is a simple tool to screen for frailty and identify older adults at risk for adverse events in the early and midterm postoperative periods.

Original languageEnglish (US)
Article numbere010139
JournalJournal of the American Heart Association
Volume7
Issue number23
DOIs
StatePublished - Dec 1 2018
Externally publishedYes

Keywords

  • Elderly
  • Function
  • Mortality
  • Surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Gait speed and 1-year mortality following cardiac surgery: A landmark analysis from the society of thoracic surgeons adult cardiac surgery database'. Together they form a unique fingerprint.

Cite this