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Gait Speed and 1-Year Mortality Following Cardiac Surgery: A Landmark Analysis From the Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Publication ,  Journal Article
Afilalo, J; Sharma, A; Zhang, S; Brennan, JM; Edwards, FH; Mack, MJ; McClurken, JB; Cleveland, JC; Smith, PK; Shahian, DM; Peterson, ED; Alexander, KP
Published in: J Am Heart Assoc
December 4, 2018

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.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

December 4, 2018

Volume

7

Issue

23

Start / End Page

e010139

Location

England

Related Subject Headings

  • Walking Speed
  • United States
  • Survival Analysis
  • Societies, Medical
  • Risk Factors
  • Proportional Hazards Models
  • Patient Readmission
  • Male
  • Kaplan-Meier Estimate
  • Humans
 

Citation

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ICMJE
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Afilalo, J., Sharma, A., Zhang, S., Brennan, J. M., Edwards, F. H., Mack, M. J., … Alexander, K. P. (2018). Gait Speed and 1-Year Mortality Following Cardiac Surgery: A Landmark Analysis From the Society of Thoracic Surgeons Adult Cardiac Surgery Database. J Am Heart Assoc, 7(23), e010139. https://doi.org/10.1161/JAHA.118.010139
Afilalo, Jonathan, Abhinav Sharma, Shuaiqi Zhang, J Matthew Brennan, Fred H. Edwards, Michael J. Mack, James B. McClurken, et al. “Gait Speed and 1-Year Mortality Following Cardiac Surgery: A Landmark Analysis From the Society of Thoracic Surgeons Adult Cardiac Surgery Database.J Am Heart Assoc 7, no. 23 (December 4, 2018): e010139. https://doi.org/10.1161/JAHA.118.010139.
Afilalo J, Sharma A, Zhang S, Brennan JM, Edwards FH, Mack MJ, et al. Gait Speed and 1-Year Mortality Following Cardiac Surgery: A Landmark Analysis From the Society of Thoracic Surgeons Adult Cardiac Surgery Database. J Am Heart Assoc. 2018 Dec 4;7(23):e010139.
Afilalo, Jonathan, et al. “Gait Speed and 1-Year Mortality Following Cardiac Surgery: A Landmark Analysis From the Society of Thoracic Surgeons Adult Cardiac Surgery Database.J Am Heart Assoc, vol. 7, no. 23, Dec. 2018, p. e010139. Pubmed, doi:10.1161/JAHA.118.010139.
Afilalo J, Sharma A, Zhang S, Brennan JM, Edwards FH, Mack MJ, McClurken JB, Cleveland JC, Smith PK, Shahian DM, Peterson ED, Alexander KP. Gait Speed and 1-Year Mortality Following Cardiac Surgery: A Landmark Analysis From the Society of Thoracic Surgeons Adult Cardiac Surgery Database. J Am Heart Assoc. 2018 Dec 4;7(23):e010139.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

December 4, 2018

Volume

7

Issue

23

Start / End Page

e010139

Location

England

Related Subject Headings

  • Walking Speed
  • United States
  • Survival Analysis
  • Societies, Medical
  • Risk Factors
  • Proportional Hazards Models
  • Patient Readmission
  • Male
  • Kaplan-Meier Estimate
  • Humans