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 longterm 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.