Gait speed is predictive of adverse cardiac intervention outcomes

by Bruce Sylvester: Gait speed is an independent predictor of adverse outcomes after cardiac surgery, researchers reported on May 11, 2016 in JAMA Cardiology.

“Gait speed can be used to refine estimates of operative risk, to support decision-making and, since incremental value is modest when used as a sole criterion for frailty, to screen older adults who could benefit from further assessment,” said Jonathan Afilalo, MD, assistant professor  in the Department of Medicine, Division of Experimental Medicine at McGill University in Montreal, and colleagues.

The purpose of the study was to assess association of 5-m gait speed with operative mortality and morbidity in older adults undergoing cardiac surgery.

The investigators performed the 5-m gait speed test with 15, 171 subjects aged 60 years or older as part of their preparation to undergo coronary artery bypass graft, aortic valve surgery, mitral valve surgery, or combined procedures.

They found that slow gait speed is an independent risk factor for operative mortality. The finding held across a range of the most commonly performed cardiac surgical procedures used to treat ischemic and valvular heart disease.

For each 0.1 meter/second decrease in gait speed (for example, 6 seconds rather than 7 seconds to walk the 5-m course comfortably), they reported an 11 percent increase in relative increase of operative mortality.

“Additional research is needed to examine the effect of gait speed on long-term hazards and patient­ centered outcomes, and to develop targeted interventions that can offset the negative impact of frailty,” the authors concluded.