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Gait Speed Predicts...
Gait Speed Predicts 30-Day Mortality After Transcatheter Aortic Valve Replacement Results From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry
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- Alfredsson, Joakim (author)
- Linköpings universitet,Medicinska fakulteten,Avdelningen för kardiovaskulär medicin,Region Östergötland, Kardiologiska kliniken US,Duke Clin Research Institute, NC 27705 USA
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- Stebbins, Amanda (author)
- Duke Clin Research Institute, NC 27705 USA
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- Brennan, J. Matthew (author)
- Duke University, NC USA
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- Matsouaka, Roland (author)
- Duke University, NC USA
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- Afilalo, Jonathan (author)
- McGill University, Canada
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- Peterson, Eric D. (author)
- Duke Clin Research Institute, NC 27705 USA; Duke University, NC USA
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- Vemulapalli, Sreekanth (author)
- Duke University, NC USA
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- Rumsfeld, John S. (author)
- University of Colorado, CO USA
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- Shahian, David (author)
- Massachusetts Gen Hospital, MA 02114 USA
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- Mack, Michael J. (author)
- Baylor Scott and White Heatlh, TX USA
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- Alexander, Karen P. (author)
- Duke Clin Research Institute, NC 27705 USA; Duke University, NC USA
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(creator_code:org_t)
- LIPPINCOTT WILLIAMS & WILKINS, 2016
- 2016
- English.
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In: Circulation. - : LIPPINCOTT WILLIAMS & WILKINS. - 0009-7322 .- 1524-4539. ; 133:14, s. 1351-1359
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background Surgical risk scores do not include frailty assessments (eg, gait speed), which are of particular importance for patients with severe aortic stenosis considering transcatheter aortic valve replacement. Methods and Results We assessed the association of 5-m gait speed with outcomes in a cohort of 8039 patients who underwent transcatheter aortic valve replacement (November 2011-June 2014) and were included in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. We evaluated the association between continuous and categorical gait speed and 30-day all-cause mortality before and after adjustment for Society of Thoracic Surgeons-predicted risk of mortality score and key variables. Secondary outcomes included in-hospital mortality, bleeding, acute kidney injury, and stroke. The overall median gait speed was 0.63 m/s (25th-75th percentile, 0.47-0.79 m/s), with the slowest walkers (<0.5 m/s) constituting 28%, slow walkers (0.5-0.83 m/s) making up 48%, and normal walkers (>0.83 m/s) constituting 24% of the population. Thirty-day all-cause mortality rates were 8.4%, 6.6%, and 5.4% for the slowest, slow, and normal walkers, respectively (P<0.001). Each 0.2-m/s decrease in gait speed corresponded to an 11% increase in 30-day mortality (adjusted odds ratio, 1.11; 95% confidence interval, 1.01-1.22). The slowest walkers had 35% higher 30-day mortality than normal walkers (adjusted odds ratio, 1.35; 95% confidence interval, 1.01-1.80), significantly longer hospital stays, and a lower probability of being discharged to home. Conclusions Gait speed is independently associated with 30-day mortality after transcatheter aortic valve replacement. Identification of frail patients with the slowest gait speeds facilitates preprocedural evaluation and anticipation of a higher level of postprocedural care. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01737528.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences (hsv//eng)
Keyword
- aged; aortic valve stenosis; heart valve diseases; transcatheter aortic valve replacement
Publication and Content Type
- ref (subject category)
- art (subject category)
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Alfredsson, Joak ...
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Stebbins, Amanda
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Brennan, J. Matt ...
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Matsouaka, Rolan ...
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Afilalo, Jonatha ...
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Peterson, Eric D ...
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Vemulapalli, Sre ...
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Rumsfeld, John S ...
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Shahian, David
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Mack, Michael J.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
- Articles in the publication
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Circulation
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Linköping University