Summary
This prospective cohort study of 8,287 older patients (median age 74 years) undergoing cardiac surgery demonstrates that slower gait speed, measured over 5 metres preoperatively, is independently associated with increased 1-year mortality and rehospitalisation. The effect was most pronounced in the 30–365 day postoperative window, where each 0.1 m/s decline in gait speed conferred approximately twofold increased mortality risk. The authors propose gait speed as a simple, practical frailty screening tool for identifying high-risk older cardiac surgery candidates.
UK applicability
These findings from the United States Society of Thoracic Surgeons Database are applicable to UK cardiac surgery programmes, as preoperative frailty assessment is increasingly recognised in UK cardiothoracic guidelines. Gait speed testing could readily be incorporated into UK preoperative assessment protocols, though adoption would require training and standardisation across centres.
Key measures
5-metre gait speed (metres per second); all-cause mortality at landmark timepoints (0–30 days, 30–365 days, >365 days); repeat hospitalisation within 1 year; hazard ratios per 0.1 m/s decrease in gait speed
Outcomes reported
The study measured all-cause mortality at 30 days, 30–365 days, and beyond 365 days post-surgery, as well as repeat hospitalisation within 1 year, stratified by gait speed tertiles. Gait speed was evaluated as a predictor of postoperative adverse events in older adults.
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