| Natural history of claudication: long-term serial follow-up study of 1244 claudicants. | |
| | |
MedLine Citation:
|
PMID: 11743546 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: The purpose of this study was to delineate the natural history of claudication and determine risk factors for ischemic rest pain (IRP) and ischemic ulceration (IU) among patients with claudication. METHODS: We prospectively collected data on 1244 men with claudication during a 15-year period, including demographics, clinical risk factors, and ankle-brachial index (ABI). We followed these patients serially with ABIs, self-reported walking distance (WalkDist), and monitoring for IRP and IU. We used Kaplan-Meier and proportional hazards modeling to find independent predictors of IRP and IU. RESULTS: Mean follow-up was 45 months; statistically valid follow-up could be carried out for as long as 12 years. ABI declined an average of 0.014 per year. WalkDist declined at an average rate of 9.2 yards per year. The cumulative 10-year risks of development of IU and IRP were 23% and 30%, respectively. In multivariate analysis using several clinical risk factors, we found that only DM (relative risk [RR], 1.8) and ABI (RR, 2.2 for 0.1 decrease in ABI) predicted the development of IRP. Similarly, only DM (RR, 3.0) and ABI (RR, 1.9 for 0.1 decrease in ABI) were significant predictors of IU. CONCLUSION: This large serial study of claudication is, to our knowledge, the longest of its kind. We documented an average rate of ABI decline of 0.014 per year and a decline in WalkDist of 9.2 yards per year. Two clinical factors, ABI and DM, were found to be associated with the development of IRP and IU. Our findings may be useful in predicting the clinical course of claudication. |
| | |
Authors:
|
R Aquino; C Johnnides; M Makaroun; J C Whittle; V S Muluk; M E Kelley; S C Muluk |
Related Documents
:
|
12180356 - Metabolic, endocrine and haemodynamic risk factors in the patient with peripheral arter... 10374226 - Age at menopause in women with type 2 diabetes mellitus. 16344426 - Cystatin c and incident peripheral arterial disease events in the elderly: results from... 17272796 - Measuring comparative risk perceptions in an urban minority population: the risk percep... 588856 - Suicide mortality in greater london: changes during the past 25 years. 1246256 - Coffee drinking and death due to coronary heart disease. |
Publication Detail:
|
Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
|
Title: Journal of vascular surgery Volume: 34 ISSN: 0741-5214 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2001 Dec |
Date Detail:
|
Created Date: 2001-12-14 Completed Date: 2002-01-18 Revised Date: 2012-10-03 |
Medline Journal Info:
|
Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 962-70 Citation Subset: IM |
Affiliation:
|
Division of Vascular Surgery, the University of Pittsburgh Medical Center and Veterans Administration Medical Center, PA 15213, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Diabetes Complications Disease Progression Exercise Test Follow-Up Studies Humans Hypertension / complications Intermittent Claudication / classification, complications*, diagnosis, physiopathology* Leg Ulcer / etiology Male Middle Aged Multivariate Analysis Pain / diagnosis, etiology Pain Measurement Pennsylvania Proportional Hazards Models Rest Risk Factors Severity of Illness Index Smoking / adverse effects Survival Analysis Ultrasonography, Doppler Veterans / statistics & numerical data Walking |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Function of the 3 portions of the inferior glenohumeral ligament: a cadaveric study.
Next Document: Infrainguinal arterial reconstructions in patients with aortoiliac occlusive disease: the influence ...