Gait Speed improves EuroSCORE II prediction

  • Felipe B de Salles
  • Omar AV Mejía
  • Luiz AF Lisboa
  • Kalil H Khalil
  • Luís RP Dallan
  • Luís AO Dallan
  • Fábio B Jatene
  • Marco AP Oliveira
  • Gustavo I Judas
  • Sergio A de Oliveira
  • Orlando Petrucci
  • Rubens T de Barros
  • Marcos G Tiveron
  • Valquíria Campagnucci
  • Felipe Machado
  • Amauri Groppo
  • Rafael Tinelli
  • Roberto Rocha e Silva
  • Alfredo Rodrigues
  • Walter Gomes
  • Marcelo Nakazone
  • Domingo Braile
  • Grupo de Estudo REPLICCAR
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Keywords

Valve Replacement Gait Speed Tertiary Care Hospital Speed Test Major Morbidity 

Background/Introduction

Traditionally cardiac surgery risk scores have worse performance in elderly patients. Frailty evaluation may improve EuroSCORE II accuracy in predicting morbimortality

Aims/Objectives

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

Method

A multicenter prospective cohort of patients undergoing coronary artery bypass and/or valve replacement or repair from 12 tertiary care hospitals in São Paulo State/Brazil. Patients were eligible if they were at least 60 years of age. Frailty was defined as slow gait speed, 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 241 patients with a mean age of 67,4 ± 8.2 years. One hundred and two patients (42.3%) were classified as slow walkers before cardiac surgery. Slow gait speed patients were more likely to be female (50.9% vs. 19.4%, p = 0.0001), insulin-dependence diabetic (23.5% vs. 13.6%, p = 0.05), had worse EuroSCORE II (3.9% × 1.8%, p = 0.001). Frail patients had more prolonged length of stay (27.5% vs 7.9%, p = 0.001) and more morbimortality (32.4% vs 15.1%, p = 0.002). Slow gait speed was an independent predictor of the composite end point after adjusting for the EuroSCORE II (odds ratio: 2.36; 95% confidence interval: 1.17 to 4.76) and increased EuroSCORE II accuracy from 67% to 71.9% in prediction of morbimortality

Discussion/Conclusion

Impaired Gait speed patients have more morbimortality. 5-meter gait speed test is an effective way to identify elderly patients at higher risk and is a simple way to improve EuroSCORE II performance

Copyright information

© de Salles et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • Felipe B de Salles
    • 1
  • Omar AV Mejía
    • 1
  • Luiz AF Lisboa
    • 1
  • Kalil H Khalil
    • 1
  • Luís RP Dallan
    • 1
  • Luís AO Dallan
    • 1
  • Fábio B Jatene
    • 1
  • Marco AP Oliveira
    • 2
  • Gustavo I Judas
    • 2
  • Sergio A de Oliveira
    • 2
  • Orlando Petrucci
    • 3
  • Rubens T de Barros
    • 4
  • Marcos G Tiveron
    • 4
  • Valquíria Campagnucci
    • 5
  • Felipe Machado
    • 5
  • Amauri Groppo
    • 6
  • Rafael Tinelli
    • 6
  • Roberto Rocha e Silva
    • 7
  • Alfredo Rodrigues
    • 8
  • Walter Gomes
    • 9
  • Marcelo Nakazone
    • 10
  • Domingo Braile
    • 10
  • Grupo de Estudo REPLICCAR
    • 11
  1. 1.Department of Cardiovascular Surgery, Heart Institute (InCor)School of Medicine of the University of São Paulo (USP)São PauloBrazil
  2. 2.Cardiovascular Surgery, Portuguese Beneficent Hospital of São PauloSão PauloBrazil
  3. 3.Department of Cardiovascular SurgeryHospital of Clinics of the University of Campinas (UNICAMP)São PauloBrazil
  4. 4.Department of Cardiovascular SurgeryHoly House of Mercy of MaríliaMaríliaBrazil
  5. 5.Department of Cardiovascular SurgeryHoly House of Mercy of São PauloSão PauloBrazil
  6. 6.Department of Cardiovascular SurgeryHoly House of Mercy of PiracicabaPiracicabaBrazil
  7. 7.Cardiovascular SurgeryPaulo Sacramento Hospital & SOBAM GroupJundiaíBrazil
  8. 8.Department of Cardiovascular SurgeryHospital of Clinics of Ribeirão PretoRibeirão PretoBrazil
  9. 9.Department of Cardiovascular SurgerySão Paulo Hospital of the Federal University of São Paulo (UNIFESP)São PauloBrazil
  10. 10.Department of Cardiovascular SurgeryHospital de Base of São José do Rio PretoSão José do Rio PretoBrazil
  11. 11.São Paulo Registry of Cardiovascular SurgerySão PaoloBrazil

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