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Slow Gait Speed and Risk of Mortality or Hospital Readmission After Myocardial Infarction in the Translational Research Investigating Underlying Disparities in Recovery from Acute Myocardial Infarction: Patients' Health Status Registry.

Publication ,  Journal Article
Dodson, JA; Arnold, SV; Gosch, KL; Gill, TM; Spertus, JA; Krumholz, HM; Rich, MW; Chaudhry, SI; Forman, DE; Masoudi, FA; Alexander, KP
Published in: J Am Geriatr Soc
March 2016

OBJECTIVES: To determine the prognostic value of slow gait in predicting outcomes 1 year after acute myocardial infarction (AMI). DESIGN: Observational cohort with longitudinal follow-up. SETTING: Twenty-four U.S. hospitals participating in the Translational Research Investigating Underlying disparities in recovery from acute Myocardial infarction: Patients' Health status Registry. PARTICIPANTS: Older adults (≥65) with in-home gait assessment 1 month after AMI (N = 338). MEASUREMENTS: Baseline characteristics and 1-year mortality or hospital readmission adjusted using Cox proportional hazards regression in older adults with slow (<0.8 m/s) versus preserved (≥0.8 m/s) gait speed. RESULTS: Slow gait was present in 181 participants (53.6%). Those with slow gait were older, more likely to be female and nonwhite, and had a higher prevalence of heart failure and diabetes mellitus. They were also more likely to die or be readmitted to the hospital within 1 year than those with preserved gait (35.4% vs 18.5%, log-rank P = .006). This association remained significant after adjusting for age, sex, and race (slow vs preserved gait hazard ratio (HR) = 1.76, 95% confidence interval (CI)=1.08-2.87, P = .02) but was no longer significant after adding clinical factors (HR = 1.23, 95% CI=0.74-2.04, P = .43). CONCLUSION: Slow gait, a marker of frailty, is common 1 month after AMI in older adults and is associated with nearly twice the risk of dying or hospital readmission at 1 year. Understanding its prognostic importance independent of comorbidities and whether routine testing of gait speed can improve care requires further investigation.

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Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

March 2016

Volume

64

Issue

3

Start / End Page

596 / 601

Location

United States

Related Subject Headings

  • United States
  • Translational Research, Biomedical
  • Risk Factors
  • Registries
  • Recovery of Function
  • Proportional Hazards Models
  • Prognosis
  • Patient Readmission
  • Myocardial Infarction
  • Male
 

Citation

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Chicago
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Dodson, J. A., Arnold, S. V., Gosch, K. L., Gill, T. M., Spertus, J. A., Krumholz, H. M., … Alexander, K. P. (2016). Slow Gait Speed and Risk of Mortality or Hospital Readmission After Myocardial Infarction in the Translational Research Investigating Underlying Disparities in Recovery from Acute Myocardial Infarction: Patients' Health Status Registry. J Am Geriatr Soc, 64(3), 596–601. https://doi.org/10.1111/jgs.14016
Dodson, John A., Suzanne V. Arnold, Kensey L. Gosch, Thomas M. Gill, John A. Spertus, Harlan M. Krumholz, Michael W. Rich, et al. “Slow Gait Speed and Risk of Mortality or Hospital Readmission After Myocardial Infarction in the Translational Research Investigating Underlying Disparities in Recovery from Acute Myocardial Infarction: Patients' Health Status Registry.J Am Geriatr Soc 64, no. 3 (March 2016): 596–601. https://doi.org/10.1111/jgs.14016.
Dodson JA, Arnold SV, Gosch KL, Gill TM, Spertus JA, Krumholz HM, Rich MW, Chaudhry SI, Forman DE, Masoudi FA, Alexander KP. Slow Gait Speed and Risk of Mortality or Hospital Readmission After Myocardial Infarction in the Translational Research Investigating Underlying Disparities in Recovery from Acute Myocardial Infarction: Patients' Health Status Registry. J Am Geriatr Soc. 2016 Mar;64(3):596–601.
Journal cover image

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

March 2016

Volume

64

Issue

3

Start / End Page

596 / 601

Location

United States

Related Subject Headings

  • United States
  • Translational Research, Biomedical
  • Risk Factors
  • Registries
  • Recovery of Function
  • Proportional Hazards Models
  • Prognosis
  • Patient Readmission
  • Myocardial Infarction
  • Male