Format

Send to

Choose Destination
J Am Geriatr Soc. 2016 Mar;64(3):596-601. doi: 10.1111/jgs.14016. Epub 2016 Mar 1.

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.

Author information

1
Leon H. Charney Division of Cardiology, Department of Medicine, School of Medicine, New York University, New York, New York.
2
Saint Luke's Mid America Heart Institute, University of Missouri at Kansas City, Kansas City, Missouri.
3
Section of Geriatrics, Yale University New Haven, New Haven, Connecticut.
4
Section of Cardiovascular Medicine, Yale University New Haven, New Haven, Connecticut.
5
Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, School of Medicine, Yale University New Haven, New Haven, Connecticut.
6
Department of Health Policy and Management, School of Public Health, Yale University New Haven, New Haven, Connecticut.
7
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
8
Division of Cardiology, Department of Medicine, School of Medicine, Washington University, St. Louis, Missouri.
9
Section of General Internal Medicine, Yale University New Haven, Connecticut.
10
Division of Geriatric Cardiology, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
11
Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Denver, Colorado.
12
Division of Cardiology, Department of Medicine, School of Medicine, Duke University, Durham, North Carolina.

Abstract

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.

KEYWORDS:

coronary artery disease; frailty; older adults; outcomes

PMID:
26926309
PMCID:
PMC4803531
[Available on 2017-03-01]
DOI:
10.1111/jgs.14016
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center