Gait speed is associated with death or readmission among patients surviving acute hypercapnic respiratory failure
Objectives Death or hospital readmission are frequent among patients surviving acute hypercapnic respiratory failure (AHRF). Severity scores are not valid to predict death or readmission after AHRF. Gait speed, a simple functional parameter, has been associated with hospital admission and death in t...
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| Language: | English |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/7/1/e000542.full |
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| author | Gatete Karege Dina Zekry Gilles Allali Dan Adler Christophe Marti |
| author_facet | Gatete Karege Dina Zekry Gilles Allali Dan Adler Christophe Marti |
| author_sort | Gatete Karege |
| collection | DOAJ |
| description | Objectives Death or hospital readmission are frequent among patients surviving acute hypercapnic respiratory failure (AHRF). Severity scores are not valid to predict death or readmission after AHRF. Gait speed, a simple functional parameter, has been associated with hospital admission and death in the general population. The purpose of this study is to highlight an association between gait speed at hospital discharge and death or readmission among AHRF survivors.Design Secondary analysis of a prospective cohort study.Settings Single Swiss tertiary hospital, pulmonary division.Participants Patients were prospectively recruited to form a cohort of patients surviving AHRF in the intensive care unit between January 2012 and May 2015.Outcome measure Gait speed was derived from a 6 min walking test (6MWT) before hospital discharge. All predictive variables were prospectively collected. Death or hospital readmission were recorded for 6 months. Univariate and multivariate analyses were performed to evaluate the association between predictive variables and death or hospital readmission.Results 71 patients performed a 6MWT. 34/71 (48%) patients died or were readmitted to the hospital during the observation period. Median gait speed was 0.7 (IQR 0.3–1.0) m/s. At 6 months, 66% (25/38) of slow walkers (gait speed <0.7 m/s) and 27% (9/33) of non-slow walkers died or were readmitted to the hospital (p=0.002). In univariate analysis, gait speed was associated with death or readmission (HR 0.41; 95% CI 0.19 to 0.90, p=0.025). In a multivariate model adjusted for age, gender, body mass index, forced expired volume, heart failure and home mechanical ventilation, gait speed remained the only variable associated with death or readmission (multivariate HR: 0.35; 95% CI 0.14 to 0.88, p=0.025).Conclusion This study suggests that a simple functional parameter such as gait speed is associated with death or hospital readmission in patients surviving AHRF.Trial registration number NCT02111876. |
| format | Article |
| id | doaj-art-f7d8d3bc387648dea88eae575673a6f0 |
| institution | Kabale University |
| issn | 2052-4439 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Respiratory Research |
| spelling | doaj-art-f7d8d3bc387648dea88eae575673a6f02024-11-24T06:10:08ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392020-09-017110.1136/bmjresp-2019-000542Gait speed is associated with death or readmission among patients surviving acute hypercapnic respiratory failureGatete Karege0Dina Zekry1Gilles Allali2Dan Adler3Christophe Marti4Division of General Internal Medicine, Geneva University Hospitals, Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandDivision of Neurology, Geneva University Hospitals, Geneve, SwitzerlandDivision of Pulmonary Diseases, Geneva University Hospitals, Geneva, Switzerlandcritical care clinicianObjectives Death or hospital readmission are frequent among patients surviving acute hypercapnic respiratory failure (AHRF). Severity scores are not valid to predict death or readmission after AHRF. Gait speed, a simple functional parameter, has been associated with hospital admission and death in the general population. The purpose of this study is to highlight an association between gait speed at hospital discharge and death or readmission among AHRF survivors.Design Secondary analysis of a prospective cohort study.Settings Single Swiss tertiary hospital, pulmonary division.Participants Patients were prospectively recruited to form a cohort of patients surviving AHRF in the intensive care unit between January 2012 and May 2015.Outcome measure Gait speed was derived from a 6 min walking test (6MWT) before hospital discharge. All predictive variables were prospectively collected. Death or hospital readmission were recorded for 6 months. Univariate and multivariate analyses were performed to evaluate the association between predictive variables and death or hospital readmission.Results 71 patients performed a 6MWT. 34/71 (48%) patients died or were readmitted to the hospital during the observation period. Median gait speed was 0.7 (IQR 0.3–1.0) m/s. At 6 months, 66% (25/38) of slow walkers (gait speed <0.7 m/s) and 27% (9/33) of non-slow walkers died or were readmitted to the hospital (p=0.002). In univariate analysis, gait speed was associated with death or readmission (HR 0.41; 95% CI 0.19 to 0.90, p=0.025). In a multivariate model adjusted for age, gender, body mass index, forced expired volume, heart failure and home mechanical ventilation, gait speed remained the only variable associated with death or readmission (multivariate HR: 0.35; 95% CI 0.14 to 0.88, p=0.025).Conclusion This study suggests that a simple functional parameter such as gait speed is associated with death or hospital readmission in patients surviving AHRF.Trial registration number NCT02111876.https://bmjopenrespres.bmj.com/content/7/1/e000542.full |
| spellingShingle | Gatete Karege Dina Zekry Gilles Allali Dan Adler Christophe Marti Gait speed is associated with death or readmission among patients surviving acute hypercapnic respiratory failure BMJ Open Respiratory Research |
| title | Gait speed is associated with death or readmission among patients surviving acute hypercapnic respiratory failure |
| title_full | Gait speed is associated with death or readmission among patients surviving acute hypercapnic respiratory failure |
| title_fullStr | Gait speed is associated with death or readmission among patients surviving acute hypercapnic respiratory failure |
| title_full_unstemmed | Gait speed is associated with death or readmission among patients surviving acute hypercapnic respiratory failure |
| title_short | Gait speed is associated with death or readmission among patients surviving acute hypercapnic respiratory failure |
| title_sort | gait speed is associated with death or readmission among patients surviving acute hypercapnic respiratory failure |
| url | https://bmjopenrespres.bmj.com/content/7/1/e000542.full |
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