What is the clinical evidence from this study?

Study design: Cohort. Population: Aortic valve stenosis (n=1082). Intervention: Decreased gait speed during hospitalization vs. Non-decreased gait speed during hospitalization. Primary outcome: Post-discharge all-cause mortality (HR 1.905, 95% CI 1.230-2.951, p=0.004).

What question did this study set out to answer?

This study aims to examine how in-hospital changes in gait speed affect post-discharge mortality in TAVI patients.

June 12, 2026Open Access

Prognostic Impact of Gait Speed Changes During Hospitalization in Patients Undergoing Transcatheter Aortic Valve Implantation

Key Result

A decline in gait speed during hospitalization for transcatheter aortic valve implantation was associated with a higher risk of post-discharge all-cause mortality, even among patients with normal baseline gait speed (HR 1.905).

Key Points

This study aims to examine how in-hospital changes in gait speed affect post-discharge mortality in TAVI patients.
Analyzed 1,082 patients who underwent TAVI from 2013 to 2022.
Gait speed measured at admission and discharge, classified into groups based on baseline speed and changes.
Multivariable Cox model used to evaluate the risk of all-cause mortality.
255 (24%) patients died during the mean follow-up of 3.1 years.
Higher mortality risk in the Normal/DG group (HR 1.905; 95% CI 1.230–2.951; P=0.004).
Slow/DG group also had increased risk (HR 2.102; 95% CI 1.186–3.728; P=0.011).

Study Design

Type

Cohort (n=1,082)

Multicenter

Structured PICO

Does a decline in gait speed during hospitalization predict post-discharge all-cause mortality in patients undergoing TAVI?

Population

1,082 older adults (mean age 85 years, 65% female) who underwent transcatheter aortic valve implantation, followed for a mean of 3.1 years.

Exposure

Decreased gait speed (decline of ≥0.1 m/s) during hospitalization for TAVI

Comparator

Non-decreased gait speed (no decline in gait speed) during hospitalization for TAVI

Outcome

Post-discharge all-cause mortalityhard clinical

A decline in gait speed during hospitalization for TAVI is a significant predictor of post-discharge all-cause mortality, independent of baseline gait speed.

Main Result

Hazard Ratio: 1.905 (95% CI 1.23–2.951)

p-value: p=0.004

Limitations

Single-center retrospective design limits generalizability
Exclusion of non-ambulatory patients and in-hospital deaths may introduce selection bias toward a healthier cohort
Unmeasured confounders such as in-hospital physical activity, acute kidney injury, and nutritional status
Potential reverse causality where perioperative complications contributed to reduced mobility
Differences in rehabilitation exposure could not be fully accounted for

Abstract

Background: Pre- and post-hospitalization gait speed are known prognostic indicators in patients undergoing transcatheter aortic valve implantation (TAVI); however, the impact of changes in gait speed during hospitalization on prognosis remains unclear. This study investigated the effect of in-hospital gait speed changes on survival outcomes. Methods and Results: We retrospectively analyzed 1,082 patients (mean age 85 years) who underwent TAVI between 2013 and 2022. Gait speed was assessed at admission (pre-TAVI) and at discharge. Patients were classified into 4 groups based on baseline gait speed (normal/slow) and in-hospitalization change (non-decreased/decreased): Normal/Non-DG (n=420); Normal/DG (n=197); Slow/Non-DG (n=385); and Slow/DG (n=80). The primary outcome was post-discharge all-cause mortality. During a mean follow up of 3.1 years, 255 (24%) patients died. In a multivariable Cox model, compared with the Normal/Non-DG group, mortality risk was higher in the Normal/DG group (hazard ratio HR 1.905; 95% confidence interval CI 1.230–2.951; P=0.004) and the Slow/DG group (HR 2.102; 95% CI 1.186–3.728; P=0.011), whereas the Slow/Non-DG group showed no significant difference (HR 1.373; 95% CI 0.927–2.034; P=0.114). Conclusions: A decline in gait speed during hospitalization was associated with a higher risk of post-discharge all-cause mortality. This association remained after multivariable adjustment, even among patients with normal gait speed at admission. These findings suggest that in-hospital gait speed change may serve as a clinically meaningful prognostic marker in patients undergoing TAVI.

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