EVALUATION OF PATIENTS WITH LOWER EXTREMITY PERIPHERAL ARTERY DISEASE BY WALKING TESTS: A PILOT STUDY

Transcription

1 EVALUATION OF PATIENTS WITH LOWER EXTREMITY PERIPHERAL ARTERY DISEASE BY WALKING TESTS: A PILOT STUDY COORDINATORS: ANDRA CIOCAN ASSOC. PROF. CLAUDIA D. GHERMAN, M.D., PH.D PROF. SORANA D. BOLBOACA, M.D., PH.D., HABIL. 1

2 CONTENT o Introduction o Material and Methods o Results o Conclusions 2

3 INTRODUCTION Source: Allison MA, Ho E, Denenberg JO, et al. Ethnic-specific prevalence of peripheral arterial disease in the United States. Am J Prev Med 2007; 32: We aimed to investigate the walking pattern of patients with lower extremity PAD (Peripheral Arterial Disease) 3

4 MATERIAL AND METHODS Second Surgical Clinic, Emergency County Hospital Cluj-Napoca March 2016 to February 2017 patient variables Patients admitted at Second Surgical Clinic Inclusion criteria passed: I=24 Exclusion criteria: E=11 walking tests: 6minutes climbing stairs treadmill Other arterial diseases 4

5 Inclusion and Exclusion Criteria Patients hospitalized for peripheral arterial disease as main diagnosis Acute ischemia Inclusion criteria Peripheral arterial disease group: stage I to IV according to the Leriche-Fontaine classification Exclusion criteria Peripheral vascular disorders: inflammatory, spasm or venous origin Age >18 years 5

6 6 Minute Walking Test Source: 6

7 Climbing Stairs Test Treadmill Test The participant can stop and rest if needed but the time keeps going. Source: Source: 7

8 Ethical Considerations The study was conducted according with the principles of the Declaration of Helsinki and was approved by the Ethical Committee of the Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca (no. 66/ ). All patients included in the study agreed for participation to the study. 8

9 RESULTS N=24 Age: 65.08±8.53 years claudication PAIN TYPE GENDER 17% F 8% continuous pain M 92% 83% 9

10 DIABETUS MELLITUS TYPE 2 YES NO ARTERIAL HYPERTENSION YES NO NO NO 38% YES 62% HEART FAILURE YES NO 25% YES 75% NO 46% YES 54% 10

11 NO 21% SMOKERS OVERWEIGHT YES 79% NO 54% YES 46% 11

12 6-minutes walking test: ±70.58 meters Climbing stairs test: 77.50±21.80 stairs Treadmill test: ±73.34 meters The results of the walking tests significantly correlate with each other (ρ>0.93, p<0.0001). 12

13 All applied tests significantly correlate with: toe gangrene (ρ> 0.52, p<0.01) toe disarticulation (ρ>0.62, p<0.002) Climbing stairs 6 minutes (meters) Treadmill (meters/ minutes) toe disarticulation /8 toe gangrene /3 without toe gangrene or disarticulation /12 13

14 CONCLUSIONS PAD more frequent in men 79% of investigated sample were smokers Half of patients were overweight 83% of the patients were with chronic pain Diabetes mellitus type 2 (62%), arterial hypertension (75%) and ischemic cardiac disease (54%) were present as co-morbidities 14

15 CONCLUSIONS Any of the applied walking tests proved equally reliable instruments, able to identify the patients with most severe PAD. Severe events that occur in the natural evolution of PAD (gangrene or disarticulation) have an important impact on patients quality of life, resulting a conssistant decrease in their performance in walking tests. 15

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