Key result
Completing ≥2,640 feet on the 12-minute walk test during cardiac rehab predicts lower all-cause mortality.
Why the study?
The 12-minute walk test may be an alternative to cardiopulmonary exercise testing in cardiac rehabilitation, but the impact of distance walked on all-cause mortality needed to be determined.
Does achieving or improving to a distance of ≥2,640 feet on the 12-minute walk test predict lower all-cause mortality in phase II cardiac rehabilitation patients?
Cohort (n=810)
Does achieving or improving to a distance of ≥2,640 feet on the 12-minute walk test predict lower all-cause mortality in phase II cardiac rehabilitation patients?
The 12-minute walk test is a valid predictor of all-cause mortality in phase II cardiac rehabilitation patients, with a distance of 2,640 feet serving as a significant prognostic threshold.
May aid mortality risk stratification in phase II cardiac rehab; hypothesis-generating for interventions targeting walk distance.
Background To assess aerobic capacity in patients undergoing treatment in a cardiac rehabilitation program (CRP), the 12-minute walk test (12MWT) may be an alternative to cardiopulmonary exercise testing. The 12MWT may be a more appropriate test based on a cardiac rehabilitation (CR) patient’s functional capacity. The objective of this study was to determine the impact of distance walked on a 12MWT on all-cause mortality in patients undergoing treatment in a phase II CRP. Methods A total of 810 phase II CR patients completed the pretreatment and posttreatment 12MWT. Patients were placed into groups based on distance completed using a half-mile (2,640 feet = 804.7 m) as the differential distance. The groups were the remained low group (LG; pre-12MWT and post-12MWT < 2,640 feet), improved group (IG; (pre-12MWT < 2,640 feet and post-12MWT ≥ 2,640 feet), and remained high group (HG; pre-12MWT and post-12MWT ≥ 2,640 feet). Covariates were assessed using Cox regression and Kaplan-Meier curves to assess mortality rates. Results Significant predictor variables of overall mortality included 12MWT distance, age, overweight/obesity, and diabetes. HG had significantly higher survivability than IG and LG. IG had higher survivability than LG, but results were not statistically significant. The 12MWT was a predictor of all-cause mortality when using a distance of 2,640 feet. Improvements in overall mortality related to completing 2,640 feet pre/post-12MWT, with improvement from below 2,640 feet to above 2,640 feet throughout CR, with significant improvements in mortality. Conclusions These results show that the 12MWT is a valid predictor of all-cause mortality in the phase II CR patient population.
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Pilmore et al. (2023) conducted a cohort in Phase II cardiac rehabilitation (n=810). 12-Minute Walk Test distance ≥2,640 feet vs. 12-Minute Walk Test distance <2,640 feet was evaluated on All-cause mortality. Completing a distance of ≥2,640 feet on the 12-minute walk test during phase II cardiac rehabilitation was a significant predictor of higher survivability and lower all-cause mortality.
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