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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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

Alfredsson, Joakim (author): Linköpings universitet,Medicinska fakulteten,Avdelningen för kardiovaskulär medicin,Region Östergötland, Kardiologiska kliniken US,Duke Clin Research Institute, NC 27705 USA

Stebbins, Amanda (author): Duke Clin Research Institute, NC 27705 USA

Brennan, J. Matthew (author): Duke University, NC USA

Matsouaka, Roland (author): Duke University, NC USA

Afilalo, Jonathan (author): McGill University, Canada

Peterson, Eric D. (author): Duke Clin Research Institute, NC 27705 USA; Duke University, NC USA

Vemulapalli, Sreekanth (author): Duke University, NC USA

Rumsfeld, John S. (author): University of Colorado, CO USA

Shahian, David (author): Massachusetts Gen Hospital, MA 02114 USA

Mack, Michael J. (author): Baylor Scott and White Heatlh, TX USA

Alexander, Karen P. (author): Duke Clin Research Institute, NC 27705 USA; Duke University, NC USA

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LIPPINCOTT WILLIAMS & WILKINS, 2016
2016
English.
In: Circulation. - : LIPPINCOTT WILLIAMS & WILKINS. - 0009-7322 .- 1524-4539. ; 133:14, s. 1351-1359

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

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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.

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By the author/editor: Alfredsson, Joak ...; Stebbins, Amanda; Brennan, J. Matt ...; Matsouaka, Rolan ...; Afilalo, Jonatha ...; Peterson, Eric D ...; show more...; Vemulapalli, Sre ...; Rumsfeld, John S ...; Shahian, David; Mack, Michael J.; Alexander, Karen ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences

Articles in the publication: Circulation

By the university: Linköping University

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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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