Key result
Slower gait speed linked to ~21% higher 1-year risk of death or HF readmission.
Why the study?
A single gait speed cutoff exists for heart failure, but continuous risk suggests multiple cutoffs could provide stepwise, attainable prognostic goals for older patients.
Does gait speed category at discharge predict 1-year all-cause death or heart failure readmission in older hospitalized patients with heart failure?
Cohort (n=7,326)
Does gait speed category at discharge predict 1-year all-cause death or heart failure readmission in older hospitalized patients with heart failure?
Hazard Ratio: 1.21 (95% CI 1.13–1.3)
In older hospitalized patients with heart failure, gait speed at discharge has multiple prognostic cutoffs (< 0.39, < 0.69, and < 1.00 m/s) that independently predict 1-year mortality or readmission, which may help set individualized physiotherapy goals.
Supports gait speed assessment for prognostication at HF discharge; leaves open whether mobility interventions improve outcomes.
BACKGROUND: Gait speed is an independent prognostic factor in patients with heart failure (HF) and is recognized as a therapeutic target. Although a single cutoff of 0.98 m/s has been proposed based on post-discharge prognosis, the continuous relationship between gait speed and outcomes suggests the possible presence of multiple cutoffs. Identifying these thresholds may help establish stepwise, attainable goals for a broad range of older HF patients. This study aimed to determine whether additional prognostic gait speed cutoffs exist at discharge in older HF patients. METHODS: We conducted a secondary analysis of the J-Proof HF, comprising 7326 hospitalized patients aged ≥ 65 years with confirmed HF. The cohort was randomly divided into a derivation (60%) and a validation (40%) cohort. The primary outcome was a composite of all-cause death or HF readmission within 1 year. Gait speed cutoffs were identified in the derivation cohort using survival classification and regression tree (CART) analysis and validated in the validation cohort. RESULTS: Three prognostic cutoffs were identified (< 0.39, < 0.69, and < 1.00 m/s), defining four gait speed categories. Patients with slower gait speed were older, had more comorbidities, and poorer physical function. Gait speed category remained independently associated with outcomes (HR 1.21, 95% CI 1.13-1.30). CONCLUSIONS: This study established new prognostic gait speed cutoffs in older HF patients, which may help set individualized physiotherapy goals based on patient mobility. TRIAL REGISTRATION: ClinicalTrials.gov identifier: UMIN000047893.
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Ogi et al. (2026) conducted a cohort in Heart failure (n=7,326). Gait speed was evaluated on Composite of all-cause death or HF readmission within 1 year (HR 1.21, 95% CI 1.13-1.30). Slower gait speed categories (<0.39, <0.69, and <1.00 m/s) were independently associated with an increased risk of all-cause death or heart failure readmission at 1 year (HR 1.21; 95% CI 1.13-1.30).
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