Slower Walking Speed Linked to Surgical Risk in
THURSDAY, Oct. 27 (HealthDay News) -- Older people who walk more
slowly than their peers may be at greater risk for complications
and disability following surgery, according to a new study.
Researchers from the University of Colorado said surgeons should
assess the elderly differently than younger patients and take
walking speed into account when determining surgical risks.
"This approach may lead to a more individualized way of deciding who should undergo surgery. We are designing tests to get away from chronologic age, and instead are now focusing on physiologic age," said study co-author Dr. Thomas Robinson, an associate professor of surgery, in a American College of Surgeons (ACS) news release.
Frailty, a condition marked by muscle loss, fatigue and a lack
of physical resiliency, can be revealed by a slow gait or walking
speed, the researchers said. In these cases the stress of an
operation could lead to serious complications, they said, which
could be avoided by assessing walking speed in a simple test before
The new research is what's known as a "proof of concept" study,
which uses a small number of strictly selected patients to show an
effect. It does not have the scientific rigor of a randomized
Researchers followed 195 patients aged 65 and older having heart
or colorectal surgery. Before surgery, the researchers gave the
patients a short timed walking test. After completing the test, the
patients were classified as fast (10 seconds or fewer),
intermediate (between 11 and 14 seconds) or slow (15 seconds or
The study showed 73 percent of the "slow" walkers who had heart
surgery were afterward sent to an institutional care facility,
compared with 17 percent of the "fast" walkers.
In addition, the researchers found that the slow walkers spent
an average of two more days in the hospital than the fast group.
Only 13 percent of the fast walkers had more than one complication
following surgery, compared with 37 percent of the slow group.
Nearly 60 percent of slow walkers who had a colorectal operation
needed institutional care after surgery, compared with 5 percent of
the fast group, the study found. Of these, slow walkers spent eight
more days in the hospital than fast walkers, and just 20 percent of
fast walkers had more than one surgical complication, compared with
56 percent of the slow group.
"Our study showed that this timed-up-and-go test is a very sharp predictor of complications and mortality," said study co-author Dr. Daniel Wu, chief surgical resident at Denver Veterans Affairs Medical Center, in the news release. "It's a cheap and simple test that may eventually lead to a change in preoperative care. You really only need a stopwatch to perform this test and the implications are huge."
Since more than half of all operations in the Unites States are
performed on people aged 65 years and older, the authors said that
better ways to define surgical risks are critical.
"The bottom line is that we can no longer assess 80-year-olds in the same way as 25-year-olds," said Wu in the release.
The authors said they plan to conduct more research on other
indications of frailty in the elderly, such as cognition,
nutritional status and grip strength to create a comprehensive test
to better determine surgical risks among older patients.
The study was slated for presentation on Wednesday at the 2011
Annual Clinical Congress of the American College of Surgeons. With
studies presented at medical meetings, the data and conclusions
should be viewed as preliminary until published in a peer-reviewed
The University of Chicago's Department of Disability and Human
Development provides more information on
frailty in the elderly.
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