Using Gait Speed to Refine Risk Assessment in Older Patients Undergoing Cardiac Surgery | Cardiology | JAMA Cardiology | JAMA Network
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Invited Commentary
June 2016

Using Gait Speed to Refine Risk Assessment in Older Patients Undergoing Cardiac Surgery

Author Affiliations
  • 1Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri
JAMA Cardiol. 2016;1(3):321-323. doi:10.1001/jamacardio.2016.0380

When cardiac surgery is considered to treat diseases of the valves or coronary arteries, an assessment and discussion of the operative risk of mortality or major morbidity is routine. Beyond simply providing the patient with a rough probability of success, this risk assessment is critical for 2 primary reasons. First, it addresses the question of whether the anticipated risks of the procedure are outweighed by the anticipated benefits in terms of survival and quality of life; that is, should an intervention be performed at all? Second, in the age of expanding transcatheter and percutaneous approaches to coronary and valve disease, risk stratification has important implications for selecting the approach taken to treat the cardiovascular condition. In the United States, the primary instruments used for the assessment of cardiac surgical risk are the Society of Thoracic Surgeons (STS) predicted risk of mortality score and the predicted risk of mortality or major morbidity score. However, the STS scores do not include factors that reflect aging-related risk beyond simply capturing chronological age, which is an important limitation since the rate and effect of aging vary considerably among individuals.

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