Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery

Jonathan Afilalo, Mark J. Eisenberg, Jean François Morin, Howard Bergman, Johanne Monette, Nicolas Noiseux, Louis P. Perrault, Karen P. Alexander, Yves Langlois, Nandini Dendukuri, Patrick Chamoun, Georges Kasparian, Sophie Robichaud, Shahyar Gharacholou, Jean François Boivin

Research output: Contribution to journalArticle

396 Citations (Scopus)

Abstract

Objectives: The purpose of this study was to test the value of gait speed, a clinical marker for frailty, to improve the prediction of mortality and major morbidity in elderly patients undergoing cardiac surgery. Background: It is increasingly difficult to predict the elderly patient's risk posed by cardiac surgery because existing risk assessment tools are incomplete. Methods: A multicenter prospective cohort of elderly patients undergoing cardiac surgery was assembled at 4 tertiary care hospitals between 2008 and 2009. Patients were eligible if they were 70 years of age or older and were scheduled for coronary artery bypass and/or valve replacement or repair. The primary predictor was slow gait speed, defined as a time taken to walk 5 m of ≥6 s. The primary end point was a composite of in-hospital postoperative mortality or major morbidity. Results: The cohort consisted of 131 patients with a mean age of 75.8 ± 4.4 years; 34% were female patients. Sixty patients (46%) were classified as slow walkers before cardiac surgery. Slow walkers were more likely to be female (43% vs. 25%, p = 0.03) and diabetic (50% vs. 28%, p = 0.01). Thirty patients (23%) experienced the primary composite end point of mortality or major morbidity after cardiac surgery. Slow gait speed was an independent predictor of the composite end point after adjusting for the Society of Thoracic Surgeons risk score (odds ratio: 3.05; 95% confidence interval: 1.23 to 7.54). Conclusions: Gait speed is a simple and effective test that may identify a subset of vulnerable elderly patients at incrementally higher risk of mortality and major morbidity after cardiac surgery.

Original languageEnglish (US)
Pages (from-to)1668-1676
Number of pages9
JournalJournal of the American College of Cardiology
Volume56
Issue number20
DOIs
StatePublished - Nov 9 2010
Externally publishedYes

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Thoracic Surgery
Morbidity
Mortality
Walkers
Walking Speed
Tertiary Healthcare
Hospital Mortality
Tertiary Care Centers
Coronary Artery Bypass
Biomarkers
Odds Ratio
Confidence Intervals

Keywords

  • Aging
  • Bypass
  • Epidemiology
  • Frailty
  • Surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery. / Afilalo, Jonathan; Eisenberg, Mark J.; Morin, Jean François; Bergman, Howard; Monette, Johanne; Noiseux, Nicolas; Perrault, Louis P.; Alexander, Karen P.; Langlois, Yves; Dendukuri, Nandini; Chamoun, Patrick; Kasparian, Georges; Robichaud, Sophie; Gharacholou, Shahyar; Boivin, Jean François.

In: Journal of the American College of Cardiology, Vol. 56, No. 20, 09.11.2010, p. 1668-1676.

Research output: Contribution to journalArticle

Afilalo, J, Eisenberg, MJ, Morin, JF, Bergman, H, Monette, J, Noiseux, N, Perrault, LP, Alexander, KP, Langlois, Y, Dendukuri, N, Chamoun, P, Kasparian, G, Robichaud, S, Gharacholou, S & Boivin, JF 2010, 'Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery', Journal of the American College of Cardiology, vol. 56, no. 20, pp. 1668-1676. https://doi.org/10.1016/j.jacc.2010.06.039
Afilalo, Jonathan ; Eisenberg, Mark J. ; Morin, Jean François ; Bergman, Howard ; Monette, Johanne ; Noiseux, Nicolas ; Perrault, Louis P. ; Alexander, Karen P. ; Langlois, Yves ; Dendukuri, Nandini ; Chamoun, Patrick ; Kasparian, Georges ; Robichaud, Sophie ; Gharacholou, Shahyar ; Boivin, Jean François. / Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery. In: Journal of the American College of Cardiology. 2010 ; Vol. 56, No. 20. pp. 1668-1676.
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abstract = "Objectives: The purpose of this study was to test the value of gait speed, a clinical marker for frailty, to improve the prediction of mortality and major morbidity in elderly patients undergoing cardiac surgery. Background: It is increasingly difficult to predict the elderly patient's risk posed by cardiac surgery because existing risk assessment tools are incomplete. Methods: A multicenter prospective cohort of elderly patients undergoing cardiac surgery was assembled at 4 tertiary care hospitals between 2008 and 2009. Patients were eligible if they were 70 years of age or older and were scheduled for coronary artery bypass and/or valve replacement or repair. The primary predictor was slow gait speed, defined as a time taken to walk 5 m of ≥6 s. The primary end point was a composite of in-hospital postoperative mortality or major morbidity. Results: The cohort consisted of 131 patients with a mean age of 75.8 ± 4.4 years; 34{\%} were female patients. Sixty patients (46{\%}) were classified as slow walkers before cardiac surgery. Slow walkers were more likely to be female (43{\%} vs. 25{\%}, p = 0.03) and diabetic (50{\%} vs. 28{\%}, p = 0.01). Thirty patients (23{\%}) experienced the primary composite end point of mortality or major morbidity after cardiac surgery. Slow gait speed was an independent predictor of the composite end point after adjusting for the Society of Thoracic Surgeons risk score (odds ratio: 3.05; 95{\%} confidence interval: 1.23 to 7.54). Conclusions: Gait speed is a simple and effective test that may identify a subset of vulnerable elderly patients at incrementally higher risk of mortality and major morbidity after cardiac surgery.",
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AU - Afilalo, Jonathan

AU - Eisenberg, Mark J.

AU - Morin, Jean François

AU - Bergman, Howard

AU - Monette, Johanne

AU - Noiseux, Nicolas

AU - Perrault, Louis P.

AU - Alexander, Karen P.

AU - Langlois, Yves

AU - Dendukuri, Nandini

AU - Chamoun, Patrick

AU - Kasparian, Georges

AU - Robichaud, Sophie

AU - Gharacholou, Shahyar

AU - Boivin, Jean François

PY - 2010/11/9

Y1 - 2010/11/9

N2 - Objectives: The purpose of this study was to test the value of gait speed, a clinical marker for frailty, to improve the prediction of mortality and major morbidity in elderly patients undergoing cardiac surgery. Background: It is increasingly difficult to predict the elderly patient's risk posed by cardiac surgery because existing risk assessment tools are incomplete. Methods: A multicenter prospective cohort of elderly patients undergoing cardiac surgery was assembled at 4 tertiary care hospitals between 2008 and 2009. Patients were eligible if they were 70 years of age or older and were scheduled for coronary artery bypass and/or valve replacement or repair. The primary predictor was slow gait speed, defined as a time taken to walk 5 m of ≥6 s. The primary end point was a composite of in-hospital postoperative mortality or major morbidity. Results: The cohort consisted of 131 patients with a mean age of 75.8 ± 4.4 years; 34% were female patients. Sixty patients (46%) were classified as slow walkers before cardiac surgery. Slow walkers were more likely to be female (43% vs. 25%, p = 0.03) and diabetic (50% vs. 28%, p = 0.01). Thirty patients (23%) experienced the primary composite end point of mortality or major morbidity after cardiac surgery. Slow gait speed was an independent predictor of the composite end point after adjusting for the Society of Thoracic Surgeons risk score (odds ratio: 3.05; 95% confidence interval: 1.23 to 7.54). Conclusions: Gait speed is a simple and effective test that may identify a subset of vulnerable elderly patients at incrementally higher risk of mortality and major morbidity after cardiac surgery.

AB - Objectives: The purpose of this study was to test the value of gait speed, a clinical marker for frailty, to improve the prediction of mortality and major morbidity in elderly patients undergoing cardiac surgery. Background: It is increasingly difficult to predict the elderly patient's risk posed by cardiac surgery because existing risk assessment tools are incomplete. Methods: A multicenter prospective cohort of elderly patients undergoing cardiac surgery was assembled at 4 tertiary care hospitals between 2008 and 2009. Patients were eligible if they were 70 years of age or older and were scheduled for coronary artery bypass and/or valve replacement or repair. The primary predictor was slow gait speed, defined as a time taken to walk 5 m of ≥6 s. The primary end point was a composite of in-hospital postoperative mortality or major morbidity. Results: The cohort consisted of 131 patients with a mean age of 75.8 ± 4.4 years; 34% were female patients. Sixty patients (46%) were classified as slow walkers before cardiac surgery. Slow walkers were more likely to be female (43% vs. 25%, p = 0.03) and diabetic (50% vs. 28%, p = 0.01). Thirty patients (23%) experienced the primary composite end point of mortality or major morbidity after cardiac surgery. Slow gait speed was an independent predictor of the composite end point after adjusting for the Society of Thoracic Surgeons risk score (odds ratio: 3.05; 95% confidence interval: 1.23 to 7.54). Conclusions: Gait speed is a simple and effective test that may identify a subset of vulnerable elderly patients at incrementally higher risk of mortality and major morbidity after cardiac surgery.

KW - Aging

KW - Bypass

KW - Epidemiology

KW - Frailty

KW - Surgery

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