Gait Speed as a predictor of mortality in COPD

Background: The 4-metre gait speed (4MGS) is a surrogate marker of physical performance and frailty. In community-dwelling older adults, slow 4MGS ( Methods: 4MGS was measured in 402 patients with stable COPD. Data on vital status were obtained at 3 years. Results: Baseline characteristics:mean age 69, FEV148%pred, 57% male. Mean (SD) 4MGS was 0.90(0.25) ms−1. Slow gait speed (≤0.80ms−1) was associated with increased risk of mortality with a hazard ratio (HR 95%CI) of 2.10 (1.25-3.53); p=0.005 (Fig 1). Each 0.1ms−1 decline in gait speed resulted in higher risk of death at 3 years (HR 1.13 (1.12-1.25);p=0.025). Multivariate analysis confirmed that 4MGS ≤0.80ms−1was an independent risk factor for all-cause death at 3 years (adjusted HR 1.78 (1.04-3.02);p=0.034). Gait speed as a single item was better than FEV1% predicted in predicting death (c-statistic 0.605 vs. 0.566). A multivariable model incorporating 4MGS, age, GOLD stage and COTE comorbidity index was a better predictor of mortality than ADO or iBODE (c-statistic 0.702 vs. 0.635 and 0.605). Conclusion: The 4MGS, a surrogate marker of physical performance and frailty, independently predicts mortality in stable COPD.