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Gait speed and prognosis in patients with idiopathic pulmonary fibrosis: a prospective cohort study

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Title: Gait speed and prognosis in patients with idiopathic pulmonary fibrosis: a prospective cohort study
Authors: Nolan, CM
Maddocks, M
Maher, TM
Banya, W
Patel, S
Barker, RE
Jones, SE
George, P
Cullinan, P
Man, WD-C
Item Type: Journal Article
Abstract: The four metre gait speed (4 MGS), a simple physical performance measure and surrogate marker of frailty, consistently predicts adverse prognosis in older adults. We hypothesised that 4 MGS could predict all-cause mortality and non-elective hospitalisation in patients with idiopathic pulmonary fibrosis (IPF).4 MGS and lung function were measured at baseline in 130 outpatients newly diagnosed with IPF. Survival status and non-elective hospital admissions were recorded over one year. We assessed the predictive value of 4 MGS (as a continuous variable and as a binary variable: slow versus preserved 4 MGS) by calculating hazard ratios (HR) using Cox proportional regression, adjusting for potential confounding variables. Receiver Operating Characteristic curves assessed discrimination between the multivariable regression models and established prognostic indices.Continuous 4 MGS and slow 4 MGS were independent predictors of all-cause mortality (4 MGS: HR 0.03 (0.01-0.31), p=0.004; slow 4 MGS: 2.63 (1.01-6.87), p=0.049) and hospitalisation (4 MGS: HR 0.02 (0.01-0.14), p<0.001; slow 4 MGS: 2.76 (1.16-6.58), p=0.02). Multivariable models incorporating 4 MGS or slow 4 MGS had better discrimination for predicting mortality than either the Gender Age Physiology index or Composite Physiologic Index.In patients with IPF, 4 MGS is an independent predictor of all-cause mortality and non-elective hospitalisation.
Issue Date: 28-Nov-2018
Date of Acceptance: 4-Nov-2018
URI: http://hdl.handle.net/10044/1/64866
DOI: https://doi.org/10.1183/13993003.01186-2018
ISSN: 0903-1936
Publisher: European Respiratory Society
Start Page: 1
End Page: 10
Journal / Book Title: European Respiratory Journal
Volume: 53
Issue: 2
Copyright Statement: © 2018 ERS. This is an author-submitted, peer-reviewed version of a manuscript that has been accepted for publication in the European Respiratory Journal, prior to copy-editing, formatting and typesetting. This version of the manuscript may not be duplicated or reproduced without prior permission from the copyright owner, the European Respiratory Society. The publisher is not responsible or liable for any errors or omissions in this version of the manuscript or in any version derived from it by any other parties. The final, copy-edited, published article, which is the version of record, is available without a subscription 18 months after the date of issue publication.
Sponsor/Funder: National Institute for Health Research
Funder's Grant Number: CS-2013-13-017
Keywords: Science & Technology
Life Sciences & Biomedicine
Respiratory System
PHYSICAL PERFORMANCE-MEASURES
MORTALITY
COMMUNITY
OUTCOMES
HOSPITALIZATION
RESPONSIVENESS
STATEMENT
CAPACITY
SURVIVAL
VALIDITY
Respiratory System
11 Medical and Health Sciences
Publication Status: Published
Conference Place: England
Online Publication Date: 2019-02-07
Appears in Collections:National Heart and Lung Institute