Gait Speed Can Predict Advanced Clinical Outcomes in Patients Who Undergo Transcatheter Aortic Valve Replacement
Why the study?
Does slow gait speed predict increased mortality in elderly patients undergoing transcatheter aortic valve replacement?
Population
1,256 elderly patients who underwent transcatheter aortic valve implantation from the OCEAN-TAVI Japanese…
Comparison
Slow gait speed or inability to walk. vs Normal or faster gait speed.
Design
Cohort
Follow-up
1 year (and midterm)
Authors
Discussion
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Member takes
Implication
Highlights severe frailty as a critical prognostic marker in TAVR evaluation; leaves.
Key Points
- To evaluate the prognostic value of baseline gait speed in elderly patients undergoing transcatheter aortic valve replacement.
- Analyzed baseline 5-meter or 15-foot gait speed in 1,256 patients undergoing transcatheter aortic valve implantation from the OCEAN-TAVI multicenter registry in Japan.
- Stratified patients using conventional speed categories (normal, slow, slowest, unable to walk) and a classification and regression tree survival model cut-off of 0.385 m/sec.
- Cumulative 1-year mortality differed significantly across conventional groups (normal: 7.6%, slow: 6.6%, slowest: 18.2%, unable to walk: 40.7%; P < 0.001) and regression tree groups (>0.385 m/sec: 7.7% vs ≤0.385 m/sec: 21.9%; P < 0.001).
- Multivariable analysis confirmed that slowest walkers (HR 1.83, 95% CI 1.03–3.26; P = 0.039), non-walkers (HR 4.28, 95% CI 2.22–8.72; P < 0.001), and patients walking ≤0.385 m/sec (HR 2.40, 95% CI 1.75–5.88; P = 0.001) had significantly higher midterm mortality.
Structured PICO
Does slow gait speed predict increased mortality in elderly patients undergoing transcatheter aortic valve replacement?
P
Population
1,256 elderly patients who underwent transcatheter aortic valve implantation (TAVI) from the OCEAN-TAVI Japanese multicenter registry.
I
Intervention
Slow gait speed or inability to walk (assessed via 5-m or 15-feet walk test).
C
Comparator
Normal or faster gait speed (>0.83 m/sec or >0.385 m/sec depending on the model).
O
Outcome
All-cause mortality (cumulative 1-year and midterm mortality).hard clinical
Gait speed is a strong, independent predictor of 1-year and midterm mortality in elderly patients undergoing TAVR, serving as a useful marker for identifying highly vulnerable patients.
Cite This Study
Kano et al. (2017) studied this question.