Abstract 4705: Gait Speed as a Predictor of Mortality and Major Morbidity in Older Adults Undergoing Cardiac Surgery: Preliminary Results From the FRAILTY ABC’S Study
Background: We sought to determine whether gait speed was a predictor of mortality and major morbidity in older adults undergoing cardiac surgery.
Methods: We conducted a multi-center prospective cohort study of older adults (≥70 years) undergoing cardiac surgery. Patients were evaluated with a standardized questionnaire and a timed 5-meter gait speed test. Multivariate logistic regression was used to determine the effect of gait speed on in-hospital major adverse postoperative events (MAPE). MAPE was defined as a composite of all-cause death, need for re-operation, stroke, renal failure, prolonged intubation, or deep sternal wound infection. Adjustment for clinical predictors of adverse outcomes was performed using the Parsonnet risk score.
Results: Among the first 100 patients enrolled, the mean age was 75.7 +/− 4.2 years, and the proportion of females was 33.7%. The cardiac surgery performed was coronary artery bypass in 61.3%, valve repair or replacement in 11.8%, and a combination in 26.9%. Using the cutoff of 6-seconds to walk 5-meters, 52.1% of patients were classified as having slow gait speed. The rate of MAPE was 35.6% in those with slow gait speed compared to 9.3% in those with normal gait speed. Slow gait speed remained a significant predictor of MAPE after adjusting for age and Parsonnet risk score, with an odds ratio of 4.1 (95% CI 1.2 to 14.7, p=0.03). In addition, out of 5 in-hospital deaths observed, all 5 had slow gait speed.
Conclusion: 5-meter gait speed may be an effective and simple test to identify the subset of vulnerable older adults who are most likely to suffer from major complications after cardiac surgery.