Gait Speed at Discharge and Risk for Readmission or Death: A Prospective Study of an Emergency Ward Population

Abstract

Background

There has been a growing interest in measuring gait speed for assessing long-term mortality and risk for hospital readmission in different populations.

Objective

We studied the association between a 10-meter gait speed test at hospital discharge and the risk for 30- and 90-day hospital readmission or death in a mixed population of patients hospitalized for emergency care.

Patients and Methods

Patients were prospectively included from 5 wards at the Karolinska University Hospital. The 10-meter gait speed test was measured on the day of discharge. Statistical analysis was performed using logistic regression.

Results

A total of 344 patients were included. Forty-one patients (n=41) were readmitted to hospital or died within 30 days, and 81 were readmitted or died within 90 days after discharge. Readmitted patients were older and had more comorbidities. A 0.1 m/s reduction in gait speed was associated with a 13% greater odds of readmission or death within 30 days (OR 1.13 [95% CI 1.00–1.26]). The area under the receiver operating characteristic curve (AUC) was 0.59 (95% CI 0.51–0.68). The results were similar for 90-day readmission or death where a 0.1 m/s decrement in gait speed was associated with an OR of 1.13 (95% CI 1.04–1.24). When age, eGFR, hemoglobin concentration, and active cancer, which all were univariate predictors of 30-day readmissions, were added to the model it yielded an AUC of 0.68 (95% CI 0.60 to 0.77).

Conclusion

In a mixed population of patients hospitalized for emergency care, low gait speed at discharge was associated with an increased risk of 30- and 90-day readmission or death. However, the test did not discriminate well between those who were readmitted or died and those who did not; therefore we do not recommend its use as a stand-alone test in this population.

Keywords:

• gait speed
• patient readmission
• hospitalization

Disclosure

Dr. Martin J Holzmann received consultancy honoraria from Actelion, Idorsia and Pfizer. The authors report no other conflicts of interest in this work.

Additional information

Funding

Dr. Daniel Hertzberg has received grants from The Swedish Society of Medicine. Dr. Martin J Holzmann holds research positions funded by the Swedish Heart-Lung Foundation (grant 20170804), and the ALF agreement between Stockholm County Council and Karolinska Institutet (grant 20170686). No specific funding was obtained for this study.