title: Is gait speed improving performance of the EuroSCORE II for prediction of early mortality and major morbidity in the elderly?
abstract: BACKGROUND
  The aim of this study was to verify if gait speed can be an incremental predictor for mortality and/or major morbidity in combination with EuroSCORE II.
  
  
  METHODS
  A single center prospective study cohort of 150 patients aged 70 years or older and undergoing cardiac surgery between August 2012 and April 2013. Slow gait speed was defined as a time taken to walk 5 meters of ≥6 second. The logistic EuroSCORE and EuroSCORE II were used for risk stratification.
  
  
  RESULTS
  The studied group had a mean age of 77.7±5.2 years and mean gait speed was 4.9±1.01 (3.0-8.6) seconds. Slow gait speed was recorded in 21 patients (14%), indicated as frail, the other 129 patients (86%) as active. The logistic EuroSCORE risk (P=0.528), was not significantly different between the two groups. The EuroSCORE II risk, however, was significantly higher (P=0.023) for the frail group. There was no mortality and no statistically significant difference in percentage of major morbidity between the frail (28.6%) versus 17.1% for the active group (P=0.209) and slow gait speed could not be identified as independent predictor. Nevertheless frailty demonstrated an incremental value to improve performance of the logistic EuroSCORE model to predict early mortality and/or major morbidity in this elderly patient population. This was not so for EuroSCORE II.
  
  
  CONCLUSIONS
  We confirm the incremental value of frailty, evaluated by gait speed, to improve mortality and morbidity prediction of the logistic EuroSCORE model in elderly undergoing cardiac surgery. We could not confirm this for the new EuroSCORE II model.
authors.affiliation: Department of Anesthesiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands - luc.noyez@radboudumc.nl.
authors.forename: Irma
authors.initials: I
authors.lastname: Prudon
authors.forename: Luc
authors.initials: L
authors.lastname: Noyez
authors.forename: Henry
authors.initials: H
authors.lastname: VAN Swieten
authors.forename: Gert J
authors.initials: GJ
authors.lastname: Scheffer
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D016009:Chi-Square Distribution; D015897:Comorbidity; D003661:Decision Support Techniques; D005260:Female; D016330:Frail Elderly; D005684:Gait; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D009426:Netherlands; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome