Ostir Glenn V, Berges Ivonne M, Ottenbacher Kenneth J, Fisher Steve R, Barr Erik, Hebel J Richard, Guralnik Jack M
Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland School of Medicine, Baltimore, MD.
Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland School of Medicine, Baltimore, MD.
Arch Phys Med Rehabil. 2015 Sep;96(9):1641-5. doi: 10.1016/j.apmr.2015.05.017. Epub 2015 Jun 9.
To classify hospitalized older patients with slow gait speed, and test the hypothesis that slow gait speed or dismobility is associated with increased mortality risk.
Prospective study.
Acute care geriatric hospital unit.
Older patients (N=289) admitted to a geriatric hospital unit.
Not applicable.
Two-year survival determined by medical record review and a search of the National Death Index.
Most of the older patients were women (61.6%) and non-Hispanic white (72.3%). A total of 213 older patients (73.7%) had gait speeds ≤0.6 m/s and were classified with dismobility; 17% (49/289) of the sample died during the 2-year follow-up. All but 5 deaths occurred in older patients with dismobility. Older patients with dismobility were more than 2.5 times as likely to die than those with gait speeds >.60 m/s (hazard ratio, 2.60; 95% confidence interval, 1.01-6.77), after adjusting for age, sex, race/ethnicity, and comorbidity.
A simple and quick screen for gait speed was evaluated in this study of hospitalized older patients. A clinical classification of dismobility could provide the inpatient health care team with meaningful information about the older patients' underlying health conditions and future prognosis, and provides an opportunity to discuss and implement treatment options with patients and their families.
对住院的步态速度缓慢的老年患者进行分类，并检验步态速度缓慢或行动不便与死亡风险增加相关的假设。
前瞻性研究。
急性护理老年医院科室。
入住老年医院科室的老年患者（N = 289）。
不适用。
通过病历审查和查询国家死亡指数确定的两年生存率。
大多数老年患者为女性（61.6%）且是非西班牙裔白人（72.3%）。共有213名老年患者（73.7%）步态速度≤0.6米/秒，并被归类为行动不便；17%（49/289）的样本在两年随访期间死亡。除5例死亡外，所有死亡均发生在行动不便的老年患者中。在调整年龄、性别、种族/民族和合并症后，行动不便的老年患者死亡可能性是步态速度>.60米/秒的患者的2.5倍以上（风险比，2.60；95%置信区间，1.01 - 6.77）。
本研究对住院老年患者评估了一种简单快速的步态速度筛查方法。行动不便的临床分类可为住院医疗团队提供有关老年患者潜在健康状况和未来预后的有意义信息，并为与患者及其家属讨论和实施治疗方案提供机会。
