Walking Test May Predict Heart Surgery Risks

Study Shows Slow Walking Speed for Elderly May Predict Heart Surgery Complications

From the WebMD Archives

Nov. 1, 2010 -- A simple walking-speed test may help predict the risk of complications for elderly people about to undergo heart surgery.

A new study shows elderly people who walk slowly, as determined by a simple gait-speed test, are three times as likely to experience complications or death following heart surgery compared to those who walk at a normal pace.

Slow walkers were also more than twice as likely to require a long hospital stay after heart surgery or be discharged to another health care facility.

Researchers say this is the first major study to test the value of gait speed -- the time it takes a person to walk 5.5 yards at a comfortable pace -- as a predictor of death or complications following heart surgery.

“Our study shows that the gait-speed test -- sometimes referred to as a geriatric vital sign -- can help clinicians identify vulnerable patients. It’s a tool that can be applied in daily practice with minimal investment,” says researcher Jonathan Afilalo, MD, MSc, of McGill University in Montreal, in a news release.

“There is no reliable eyeball test to identify frailty or whether someone is fit to undergo cardiac surgery or not,” says Afilalo. “An elderly patient may look good in a resting state in a hospital bed, but this can be misleading.”

Walking Speed Predicts Risks

In the study, published in the Journal of the American College of Cardiology, researchers tested the gait speed of 131 people age 70 or over before they underwent heart surgery at one of four different university health care centers in the U.S. and Canada. A slow gait speed was defined as taking more than six seconds to walk 5.5 yards.

The results showed people with a slow gait speed were three times more likely to experience a major complication or death and twice as likely to have a prolonged hospital stay following heart surgery compared with those with a normal walking speed.

Researchers found women and people with diabetes were nearly twice as likely to be slow walkers. Overall, 43% of women and 25% of men had a slow gait speed along with 50% of people with diabetes vs. 28% of those without.

Continued

The study suggests elderly women with a slow gait speed faced the greatest risks following heart surgery and were eight times more likely to die or experience major complications.

“Future studies need to further explore these gender differences and investigate targeted interventions for elderly patients with slow gait speed,” says Afilalo. “It often wasn’t the thin elderly lady who was most likely to be frail as most might have guessed, but the heavier one, casting even more doubt on the eyeball test for frailty.”

In an editorial that accompanies the study, Joseph C. Cleveland JR, MD, of the University of Colorado Health Sciences Center in Denver, says the gait-speed test may be an important new tool for evaluating the increasing number of elderly people considering heart surgery.

“This new screening tool -- consisting of an observer, a stopwatch and a well lit hallway -- is reproducible and, I believe will be extraordinarily cost-effective,” writes Cleveland.

WebMD Health News Reviewed by Laura J. Martin, MD on November 01, 2010

Sources

SOURCES:

Afilalo, J. Journal of the American College of Cardiology, Nov. 9, 2010; vol 56: pp 1668-1676.

News release, Journal of the American College of Cardiology.

Cleveland, J. Journal of the American College of Cardiology, Nov. 9, 2010; vol 56: 1677-1678.

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