Pulse Brain · Growing Health Evidence Index
Tier 3 — Observational / field trialPeer-reviewed

Gait Speed and Operative Mortality in Older Adults Following Cardiac Surgery

Jonathan Afilalo, Sunghee Kim, Sean M. O’Brien, James M. Brennan, Fred H. Edwards, Michael J. Mack, James B. McClurken, Joseph C. Cleveland, Peter K. Smith, David M. Shahian, Karen P. Alexander

JAMA Cardiology · 2016

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Summary

This prospective cohort study of 15,171 patients aged 60 years or older undergoing cardiac surgery examined whether gait speed—a simple frailty measure—could improve prediction of operative risk. Slower gait speed was independently associated with increased 30-day mortality even after adjusting for established surgical risk models, with those in the slowest tertile (<0.83 m/s) having 3.16 times higher mortality odds than the fastest tertile (>1.00 m/s). The findings suggest gait speed could be a useful adjunct to existing risk prediction tools in preoperative assessment of older cardiac surgery patients, although its additive predictive value was modest.

UK applicability

These findings are applicable to UK cardiac surgery practice, as they derive from standardised surgical procedures and risk assessment conducted across multiple centres. However, adoption would require integration of the 5-metre gait speed test into routine preoperative assessment protocols in UK cardiac centres, which would necessitate training, standardisation, and evaluation of implementation feasibility.

Key measures

5-metre gait speed (metres per second); 30-day operative mortality; composite outcome of mortality or major morbidity; odds ratios by gait speed tertile; C statistic and integrated discrimination improvement

Outcomes reported

The study measured 30-day all-cause operative mortality and a composite outcome of mortality or major morbidity during index hospitalisation in older adults undergoing cardiac surgery. Gait speed was evaluated as an independent predictor of these outcomes.

Theme
Nutrition & health
Subject
Other / interdisciplinary
Study type
Research
Study design
Observational cohort
Source type
Peer-reviewed study
Status
Published
Geography
United States
System type
Human clinical
DOI
10.1001/jamacardio.2016.0316
Catalogue ID
BFmor3gavc-d79rri

Topic tags

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