Kentaro Kamiya1, Nobuaki Hamazaki2,3, Yuya Matsue4,5, Alessandro Mezzani6, Ugo Corrà6, Ryota Matsuzawa3, Kohei Nozaki3, Shinya Tanaka2, Emi Maekawa7, Chiharu Noda7, Minako Yamaoka‐Tojo2,1, Atsuhiko Matsunaga1, Takashi Masuda2,1, Junya Ako7
1Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Japan
2Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Japan
3Department of Rehabilitation, Kitasato University Hospital, Japan
4Department of Cardiology, Kameda Medical Center, Japan
5Department of Cardiology, University Medical Center Groningen, The Netherlands
6Department of Cardiac Rehabilitation, Salvatore Maugeri Foundation, Italy
7Department of Cardiovascular Medicine, Kitasato University School of Medicine, Japan
Tóm tắt
Background Although gait speed and six-minute walk distance are used to assess functional capacity in older patients with cardiovascular disease, their prognostic capabilities have not been directly compared. Methods The study population was identified from the Kitasato University Cardiac Rehabilitation Database and consisted of 1474 patients ≥60 years old with a mean age of 72.2 ± 7.1 years that underwent evaluation of both usual gait speed and six-minute walk distance in routine geriatric assessment between 1 June 2008–30 September 2015. Both gait speed and six-minute walk distance were determined on the same day at hospital discharge. Results Mean gait speed and six-minute walk distance in the whole population were 1.04 m/s and 381 m, respectively, and were strongly positively correlated ( r = 0.80, p < 0.001). A total of 180 deaths occurred during a follow-up of 2.3 ± 1.9 years. After adjusting for confounding factors, both gait speed (adjusted hazard ratio per 0.1 m/s increase: 0.87, 95% confidence interval: 0.81–0.93, p < 0.001) and six-minute walk distance (adjusted hazard ratio per 10-metre increase: 0.96, 95% confidence interval: 0.94–0.97, p < 0.001) were independent predictors of all-cause mortality. There was no significant difference in prognostic capability between gait speed and six-minute walk distance (c-index: 0.64 (95% confidence interval: 0.60–0.69) and 0.66 (95% confidence interval: 0.61–0.70), respectively, p = 0.357). Conclusions Gait speed and six-minute walk distance showed similar prognostic predictive ability for all-cause mortality in older cardiovascular disease patients, indicating the potential utility of gait speed as a simple risk stratification tool in older cardiovascular disease patients.
