Slow Gait Speed and Risk of Mortality or Hospital Readmission After Myocardial Infarction in the Translational Research Investigating Underlying Disparities in Recovery from Acute Myocardial Infarction: Patients' Health Status Registry

Objectives To determine the prognostic value of slow gait in predicting outcomes 1 year after acute myocardial infarction (AMI). Design Observational cohort with longitudinal follow‐up. Setting Twenty‐four U.S. hospitals participating in the Translational Research Investigating Underlying disparitie...

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Veröffentlicht in:Journal of the American Geriatrics Society (JAGS) Jg. 64; H. 3; S. 596 - 601
Hauptverfasser: Dodson, John A., Arnold, Suzanne V., Gosch, Kensey L., Gill, Thomas M., Spertus, John A., Krumholz, Harlan M., Rich, Michael W., Chaudhry, Sarwat I., Forman, Daniel E., Masoudi, Frederick A., Alexander, Karen P.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Blackwell Publishing Ltd 01.03.2016
Wiley Subscription Services, Inc
Schlagworte:
Adults
Aged
Aged, 80 and over
coronary artery disease
Diabetes
Female
Follow-Up Studies
frailty
Gait
Health disparities
Health status
Health Status Disparities
Heart attacks
Heart failure
Hospitalization
Hospitals
Humans
Longitudinal Studies
Male
Medical prognosis
Mortality
Myocardial infarction
Myocardial Infarction - mortality
Myocardial Infarction - physiopathology
older adults
Older people
outcomes
Patient Readmission - statistics & numerical data
Patients
Prognosis
Proportional Hazards Models
Race
Readmission
Recovery
Recovery of Function
Registries
Rehabilitation
Risk Factors
Translational Medical Research
United States
Walking
United States
coronary artery disease
older adults
frailty
outcomes
ISSN:0002-8614, 1532-5415
Online-Zugang:Volltext
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Zusammenfassung:Objectives To determine the prognostic value of slow gait in predicting outcomes 1 year after acute myocardial infarction (AMI). Design Observational cohort with longitudinal follow‐up. Setting Twenty‐four U.S. hospitals participating in the Translational Research Investigating Underlying disparities in recovery from acute Myocardial infarction: Patients' Health status Registry. Participants Older adults (≥65) with in‐home gait assessment 1 month after AMI (N = 338). Measurements Baseline characteristics and 1‐year mortality or hospital readmission adjusted using Cox proportional hazards regression in older adults with slow (<0.8 m/s) versus preserved (≥0.8 m/s) gait speed. Results Slow gait was present in 181 participants (53.6%). Those with slow gait were older, more likely to be female and nonwhite, and had a higher prevalence of heart failure and diabetes mellitus. They were also more likely to die or be readmitted to the hospital within 1 year than those with preserved gait (35.4% vs 18.5%, log‐rank P = .006). This association remained significant after adjusting for age, sex, and race (slow vs preserved gait hazard ratio (HR) = 1.76, 95% confidence interval (CI)=1.08–2.87, P = .02) but was no longer significant after adding clinical factors (HR = 1.23, 95% CI=0.74–2.04, P = .43). Conclusion Slow gait, a marker of frailty, is common 1 month after AMI in older adults and is associated with nearly twice the risk of dying or hospital readmission at 1 year. Understanding its prognostic importance independent of comorbidities and whether routine testing of gait speed can improve care requires further investigation.
Bibliographie:National Heart, Lung, and Blood Institute (NHBLI) - No. P50 HL077113; No. K23 HL116799; No. U01 HL105270-05
Alliance for Academic Internal Medicine-Association of Specialty Professors
ArticleID:JGS14016
istex:8EADA33F78F2181D93D3E37AD4227FE1C89A2B93
John A. Hartford Foundation
Atlantic Philanthropies, Inc.
American College of Cardiology
ark:/67375/WNG-8Z3T6156-G
National Institute of Aging (NIA) - No. R03AG045067; No. K07AG043587
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ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.14016