Gait Speed as an Incremental Predictor of Mortality and Major Morbidity in Elderly Patients Undergoing Cardiac Surgery
Open accessAbstract
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 post-operative 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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Frailty increases hospital length of stay and adverse outcomes in patients admitted for CVD, HF, CAD, and associated procedures and exacerbates risks of long-term disability thereafter.
“Frailty increases hospital length of stay and adverse outcomes in patients admitted for CVD, HF, CAD,41 and associated procedures (eg, cardiac valve replacement or arterial vascular surgery [aortic or lower limb arterial intervention])45,46 and exacerbates risks of long-term disability thereafter.”
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- Authors
- Afilalo, J., Eisenberg, M. J., Morin, J.-F., Bergman, H., Monette, J., Noiseux, N., Perrault, L. P., Alexander, K. P., Langlois, Y., Dendukuri, N., Chamoun, P., Kasparian, G., Robichaud, S., Gharacholou, S. M., & Boivin, J.-F.
- Affiliations
- Jewish General Hospital (CA)
- Hôtel-Dieu de Montréal (CA)
- Montreal Heart Institute (CA)
- Duke University (US)
- McGill University (CA)
- Corresponding author
- Afilalo, Jonathan
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2010-11
- Volume
- 56
- Issue
- 20
- Pages
- 1668-1676
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1968963305
- Cited by
- 746
- References
- 41
- Citations by year
- 2026: 13 · 2025: 18 · 2024: 29 · 2023: 34 · 2022: 39 · 2021: 62 · 2020: 64 · 2019: 61 · 2018: 60 · 2017: 69 · 2016: 68 · 2015: 67 · 2014: 51 · 2013: 50 · 2012: 41
- FWCI
- 13.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Innovative Research Group Project of the National Natural Science Foundation of China
- Jewish General Hospital
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Keywords
- walking speed, frailty, elderly patients, cardiac surgery, postoperative mortality, major morbidity, risk prediction, coronary artery bypass grafting, valve replacement, Society of Thoracic Surgeons risk score, preoperative assessment
- MeSH terms
- Aged, Exercise Test, Female, Follow-Up Studies, Gait, Heart Diseases, Cardiac Surgical Procedures, Humans, Male, Morbidity, Prognosis, Prospective Studies, Quebec, United States, Survival Rate, Confidence Intervals, Odds Ratio
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