Gait speed can predict disability, mortality, and hospitalization in patients with blood cancers, according to research published in Blood.
Researchers evaluated the incorporation of gait speed and grip strength assessment into the clinical workflow to predict survival and acute care or emergency department utilization. Overall, 314 patients aged 75 years and older with myelodysplastic syndromes, leukemia, myeloma, or lymphoma were enrolled.
A decrease in gait speed by 0.1 m/s was associated with higher mortality (hazard ratio [HR], 1.22; 95% CI, 1.15-1.30), a 33% increase in the odds of unplanned hospitalization (odds ratio [OR], 1.33; 95% CI, 1.16-1.51), and a 34% increase in visits to emergency departments (OR, 1.34; 95% CI, 1.17-1.53). Results were consistent in patients with low-risk and good performance status.
A decrease in grip strength of 5 kg was associated with increased mortality (HR, 1.24; 95% CI, 1.04-1.52) but not gait speed. Grip strength did not correlate with utilization of acute or emergency care.
Gait speed as an assessment of frailty in routine cancer care for older patients is recommended by the American Society of Clinical Oncology and the National Comprehensive Cancer Network. This is because gait speed is a brief, objective measure of function and frailty that is easily measurable, requiring only a stopwatch and delivered over a short 4-meter course. Testing gait speed could provide an overview of a patient’s functional status and other age-related conditions such as cognitive impairment, neuropathy, and depression.
In this study, the predictive power of gait speed and other covariates was similar to validated frailty indexes and covariates. The association with survival was stronger than previous studies.
The authors concluded that gait speed can predict survival and hospitalization among older patients with hematologic toxicities and can risk stratify patients. Measuring gait speed as routine assessment of physical function can improve patient outcomes and can be used as an outcome in clinical trials.
1. Liu M, DuMontier C, Murillo A, et al. Gait speed, grip strength and clinical outcomes in older patients with hematologic malignancies [published online June 5, 2019]. Blood. doi:10.1182/blood.2019000758