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Predictive Factors of Peripheral Arterial Disease in Home Care Patients

Year 2024, Volume: 16 Issue: 3, 225 - 232, 29.10.2024
https://doi.org/10.18521/ktd.1439261

Abstract

Objective: The aim of the present study was to investigate the predictive factors of peripheral arterial disease (PAD) in home care patients.
Materials and Methods: This descriptive study was conducted in Istanbul with 285 homebound patients who applied for the first time to receive services from the Home Health Care Unit of a tertiary hospital between 01.07.2014 and 01.12.2014. The patients having known PAD diagnosis were excluded. Sociodemographic characteristics, home dependency duration, chronic diseases, medications used and smoking status were recorded. Then, deformities in the patients' toenails, peripheral hair loss, foot wounds were recorded, and the patients' functional status and skinfold thickness were evaluated peripheral arterial disease was evaluated by ankle–brachial index (ABI). An ABI below 0.9 was considered indicative of PAD. A chi-square test, Mann–Whitney U test and a logistic regression analysis were used in the statistical analysis.
Results: The mean age of the participants was 75.84±1.17 years (34% M; 65% F). Peripheral artery disease was detected in 16.8% (n=48) of the patients. Current or former smoking (β: 4.09), peripheral hair loss (β: 3.42), deformity of toenails (β: 3.02), and increased skinfold thickness (β: 1.124) were identified as predictors of PAD.
Conclusion: The findings of the present study suggest that home healthcare providers should inquire about the patient's smoking history, assess skinfold thickness, and examine the toes for hair loss and deformities, to predict PAD.

References

  • 1. McDermott MM, Guralnik JM, Ferrucci L, Tian L, Liu K, Liao Y, et al. Asymptomatic peripheral arterial disease is associated with more adverse lower extremity characteristics than intermittent claudication. Circulation. 2008;117(19):2484-91.
  • 2. Karabay Ö, Karaçelik M, Yilik L, Tekin N, Iriz AB, Kumdereli S, et al. Iskemik periferik arter hastaliǧi: Bir tarama çalismasi. Turkish Journal of Thoracic and Cardiovascular Surgery. 2012;20(3):450-7.
  • 3. Vural T, Tan MN, Kartal M, Güldal AD. Detecting peripheral arterial disease in primary care: A population based study. Korean Journal of Family Medicine. 2020;41(1):61-7.
  • 4. Ouriel K. Detection of peripheral arterial disease in primary care. 2001;286:1380-1.
  • 5. Diehm C, Schuster A, Allenberg JR, Darius H, Haberl R, Lange S, et al. High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: Cross-sectional study. Atherosclerosis. 2004;172(1):95-105.
  • 6. Zanati SG, Mouraria GG, Matsubara LS, Giannini M, Matsubara BB. Profile of cardiovascular risk factors and mortality in patients with symptomatic peripheral arterial disease. Clinics. 2009;64(4):323-6.
  • 7. Hajibandeh SS, Hajibandeh SS, Shah S, Child E, Antoniou GA, Torella F. Prognostic significance of ankle brachial pressure index: A systematic review and meta-analysis. 2017;25:208-24.
  • 8. Ferket BS, Spronk S, Colkesen EB, Hunink MGM. Systematic review of guidelines on peripheral artery disease screening. 2012;125.
  • 9. Aboyans V, Ricco JB, Bartelink MLEL, Björck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS). European Heart Journal. 2018;39(9):763-816.
  • 10. Gornik HL, Aronow HD, Goodney PP, Arya S, Brewster LP, Byrd L, et al. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. 2024;149:e1313-e410.
  • 11. Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol. 1989;42(8):703-9.
  • 12. Atcc. WHOCC - ATC/DDD Index [Internet]. Norway: Norwegian Institute of Public Health WHO Collaborating Centre for Drug Statistics Methodology; 2024 Jan [cited 2024 June 12] Available from: https://www.whocc.no/atc_ddd_index/?code=C&showdescription=no
  • 13. Carbayo JA, Divisón JA, Escribano J, López-Abril J, López de Coca E, Artigao LM, et al. Using ankle-brachial index to detect peripheral arterial disease: Prevalence and associated risk factors in a random population sample. Nutrition, Metabolism and Cardiovascular Diseases. 2007;17(1):41-9.
  • 14. Menke A, Muntner P, Wildman RP, Dreisbach AW, Raggi P. Relation of Borderline Peripheral Arterial Disease to Cardiovascular Disease Risk. American Journal of Cardiology. 2006;98(9):1226-30.
  • 15. Cacoub P, Cambou JP, Kownator S, Belliard JP, Beregi JP, Branchereau A, et al. Prevalence of peripheral arterial disease in high-risk patients using ankle-brachial index in general practice: A cross-sectional study. International Journal of Clinical Practice. 2009;63(1):63-70.
  • 16. Ostchega Y, Paulose-Ram R, Dillon CF, Gu Q, Hughes JP. Prevalence of peripheral arterial disease and risk factors in persons aged 60 and older: Data from the National Health and Nutrition Examination Survey 1999-2004. Journal of the American Geriatrics Society. 2007;55(4):583-9.
  • 17. Bergiers S, Vaes B, Degryse J. To screen or not to screen for peripheral arterial disease in subjects aged 80 and over in primary health care: A cross-sectional analysis from the BELFRAIL study. BMC Family Practice. 2011;12(1):39-.
  • 18. Tekin N, Baskan M, Yesilkayali T, Karabay O. Prevalence of peripheral arterial disease and related risk factors in Turkish elders. BMC Family Practice. 2011;12.
  • 19. Criqui MH, Aboyans V. Epidemiology of Peripheral Artery Disease. Circulation Research. 2015;116(9):1509-26.
  • 20. Sigvant B, Wiberg-Hedman K, Bergqvist D, Rolandsson O, Andersson B, Persson E, et al. A population-based study of peripheral arterial disease prevalence with special focus on critical limb ischemia and sex differences. Journal of Vascular Surgery. 2007;45(6):1185-91.
  • 21. Weiss NS, McClelland R, Criqui MH, Wassel CL, Kronmal R. Incidence and predictors of clinical peripheral artery disease in asymptomatic persons with a low ankle-brachial index. Journal of medical screening. 2018;25(4):218-22.
  • 22. Kownator S, Cambou JP, Cacoub P, Léger P, Luizy F, Herrmann MA, et al. Prevalence of unknown peripheral arterial disease in patients with coronary artery disease: Data in primary care from the IPSILON study. Archives of Cardiovascular Diseases. 2009;102(8-9):625-31.
  • 23. Joosten MM, Pai JK, Bertoia ML, Rimm EB, Spiegelman D, Mittleman MA, et al. Associations between conventional cardiovascular risk factors and risk of peripheral artery disease in men. JAMA - Journal of the American Medical Association. 2012;308(16):1660-7.
  • 24. Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: Results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation. 2004;110(6):738-43.
  • 25. Hirsch AT, Criqui MH, Treat-Jacobson D, Regensteiner JG, Creager MA, Olin JW, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. Journal of the American Medical Association. 2001;286(11):1317-24.
  • 26. Armstrong DW, Tobin C, Matangi MF. The accuracy of the physical examination for the detection of lower extremity peripheral arterial disease. Can J Cardiol. 2010;26(10):e346-50.
  • 27. Khan NA, Rahim SA, Anand SS, Simel DL, Panju A. Does the clinical examination predict lower extremity peripheral arterial disease? JAMA. 2006;295(5):536-46.
  • 28. McDermott MM, Greenland P, Liu K, Guralnik JM, Criqui MH, Dolan NC, et al. Leg symptoms in peripheral arterial disease: associated clinical characteristics and functional impairment. JAMA. 2001;286(13):1599-606.
  • 29. McDermott MM, Mehta S, Greenland P. Exertional leg symptoms other than intermittent claudication are common in peripheral arterial disease. Arch Intern Med. 1999;159(4):387-92.

Evde Bakım Hastalarında Periferik Arter Hastalığını Öngörücü Faktörler

Year 2024, Volume: 16 Issue: 3, 225 - 232, 29.10.2024
https://doi.org/10.18521/ktd.1439261

Abstract

Amaç: Çalışmanın amacı evde bakım hastalarında periferik arter hastalığı için (PAH) öngörücü faktörlerin araştırılmasıdır.
Gereç ve Yöntem: Tanımlayıcı tipte olan bu araştırma, İstanbul'da 01.07.2014-01.12.2014 tarihleri arasında üçüncü basamak bir hastanenin Evde Sağlık Birimine hizmet almak için ilk kez başvuran 285 hasta ile gerçekleştirilmiştir. Bilinen PAH tanısı olan hastalar çalışma dışı bırakılmıştır. Sosyodemografik özellikler, yatağa bağımlı kalma süresi, kronik hastalıklar, kullanılanı ilaçlar ve sigara içme durumu kaydedilmiştir. Daha sonra hastaların ayak tırnaklarında şekil bozukluğu, periferik kıl kaybı, ayak yaraları kaydedilmiş, hastaların fonksiyonel durumları ile deri kıvrım kalınlıkları değerlendirilmiştir. PAH ayak bileği-kol indeksi (ABI) ile değerlendirilmiş ve 0.9'un altı PAH olarak kabul edilmiştir. İstatistiksel analizde ki-kare testi, Mann-Whitney U testi ve lojistik regresyon analizi kullanılmıştır.
Bulgular: Katılımcıların yaş ortalaması 75,84±1,17 yıldır (%34 E; %65 K). Hastaların %16,8'inde (n=48) periferik arter hastalığı saptanmıştır. Halen veya geçmişte sigara kullanımı (β:4.09), periferik kıl kaybı (β:3.42), ayak tırnaklarında şekil bozukluğu (β:3.02) ve deri kıvrım kalınlığında artış (β:1.124), PAH varlığını öngören faktörler olarak belirlenmiştir.
Sonuç: Bu araştırmanın bulguları, evde bakım hizmeti sunanların PAH'ı öngörebilmek için hastaların sigara içme geçmişini sorgulaması, deri kıvrım kalınlığını değerlendirmesi ve kıllarda dökülme ve tırnak deformiteleri açısından ayak parmaklarını incelemesi gerektiğini göstermektedir.

References

  • 1. McDermott MM, Guralnik JM, Ferrucci L, Tian L, Liu K, Liao Y, et al. Asymptomatic peripheral arterial disease is associated with more adverse lower extremity characteristics than intermittent claudication. Circulation. 2008;117(19):2484-91.
  • 2. Karabay Ö, Karaçelik M, Yilik L, Tekin N, Iriz AB, Kumdereli S, et al. Iskemik periferik arter hastaliǧi: Bir tarama çalismasi. Turkish Journal of Thoracic and Cardiovascular Surgery. 2012;20(3):450-7.
  • 3. Vural T, Tan MN, Kartal M, Güldal AD. Detecting peripheral arterial disease in primary care: A population based study. Korean Journal of Family Medicine. 2020;41(1):61-7.
  • 4. Ouriel K. Detection of peripheral arterial disease in primary care. 2001;286:1380-1.
  • 5. Diehm C, Schuster A, Allenberg JR, Darius H, Haberl R, Lange S, et al. High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: Cross-sectional study. Atherosclerosis. 2004;172(1):95-105.
  • 6. Zanati SG, Mouraria GG, Matsubara LS, Giannini M, Matsubara BB. Profile of cardiovascular risk factors and mortality in patients with symptomatic peripheral arterial disease. Clinics. 2009;64(4):323-6.
  • 7. Hajibandeh SS, Hajibandeh SS, Shah S, Child E, Antoniou GA, Torella F. Prognostic significance of ankle brachial pressure index: A systematic review and meta-analysis. 2017;25:208-24.
  • 8. Ferket BS, Spronk S, Colkesen EB, Hunink MGM. Systematic review of guidelines on peripheral artery disease screening. 2012;125.
  • 9. Aboyans V, Ricco JB, Bartelink MLEL, Björck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS). European Heart Journal. 2018;39(9):763-816.
  • 10. Gornik HL, Aronow HD, Goodney PP, Arya S, Brewster LP, Byrd L, et al. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. 2024;149:e1313-e410.
  • 11. Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol. 1989;42(8):703-9.
  • 12. Atcc. WHOCC - ATC/DDD Index [Internet]. Norway: Norwegian Institute of Public Health WHO Collaborating Centre for Drug Statistics Methodology; 2024 Jan [cited 2024 June 12] Available from: https://www.whocc.no/atc_ddd_index/?code=C&showdescription=no
  • 13. Carbayo JA, Divisón JA, Escribano J, López-Abril J, López de Coca E, Artigao LM, et al. Using ankle-brachial index to detect peripheral arterial disease: Prevalence and associated risk factors in a random population sample. Nutrition, Metabolism and Cardiovascular Diseases. 2007;17(1):41-9.
  • 14. Menke A, Muntner P, Wildman RP, Dreisbach AW, Raggi P. Relation of Borderline Peripheral Arterial Disease to Cardiovascular Disease Risk. American Journal of Cardiology. 2006;98(9):1226-30.
  • 15. Cacoub P, Cambou JP, Kownator S, Belliard JP, Beregi JP, Branchereau A, et al. Prevalence of peripheral arterial disease in high-risk patients using ankle-brachial index in general practice: A cross-sectional study. International Journal of Clinical Practice. 2009;63(1):63-70.
  • 16. Ostchega Y, Paulose-Ram R, Dillon CF, Gu Q, Hughes JP. Prevalence of peripheral arterial disease and risk factors in persons aged 60 and older: Data from the National Health and Nutrition Examination Survey 1999-2004. Journal of the American Geriatrics Society. 2007;55(4):583-9.
  • 17. Bergiers S, Vaes B, Degryse J. To screen or not to screen for peripheral arterial disease in subjects aged 80 and over in primary health care: A cross-sectional analysis from the BELFRAIL study. BMC Family Practice. 2011;12(1):39-.
  • 18. Tekin N, Baskan M, Yesilkayali T, Karabay O. Prevalence of peripheral arterial disease and related risk factors in Turkish elders. BMC Family Practice. 2011;12.
  • 19. Criqui MH, Aboyans V. Epidemiology of Peripheral Artery Disease. Circulation Research. 2015;116(9):1509-26.
  • 20. Sigvant B, Wiberg-Hedman K, Bergqvist D, Rolandsson O, Andersson B, Persson E, et al. A population-based study of peripheral arterial disease prevalence with special focus on critical limb ischemia and sex differences. Journal of Vascular Surgery. 2007;45(6):1185-91.
  • 21. Weiss NS, McClelland R, Criqui MH, Wassel CL, Kronmal R. Incidence and predictors of clinical peripheral artery disease in asymptomatic persons with a low ankle-brachial index. Journal of medical screening. 2018;25(4):218-22.
  • 22. Kownator S, Cambou JP, Cacoub P, Léger P, Luizy F, Herrmann MA, et al. Prevalence of unknown peripheral arterial disease in patients with coronary artery disease: Data in primary care from the IPSILON study. Archives of Cardiovascular Diseases. 2009;102(8-9):625-31.
  • 23. Joosten MM, Pai JK, Bertoia ML, Rimm EB, Spiegelman D, Mittleman MA, et al. Associations between conventional cardiovascular risk factors and risk of peripheral artery disease in men. JAMA - Journal of the American Medical Association. 2012;308(16):1660-7.
  • 24. Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: Results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation. 2004;110(6):738-43.
  • 25. Hirsch AT, Criqui MH, Treat-Jacobson D, Regensteiner JG, Creager MA, Olin JW, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. Journal of the American Medical Association. 2001;286(11):1317-24.
  • 26. Armstrong DW, Tobin C, Matangi MF. The accuracy of the physical examination for the detection of lower extremity peripheral arterial disease. Can J Cardiol. 2010;26(10):e346-50.
  • 27. Khan NA, Rahim SA, Anand SS, Simel DL, Panju A. Does the clinical examination predict lower extremity peripheral arterial disease? JAMA. 2006;295(5):536-46.
  • 28. McDermott MM, Greenland P, Liu K, Guralnik JM, Criqui MH, Dolan NC, et al. Leg symptoms in peripheral arterial disease: associated clinical characteristics and functional impairment. JAMA. 2001;286(13):1599-606.
  • 29. McDermott MM, Mehta S, Greenland P. Exertional leg symptoms other than intermittent claudication are common in peripheral arterial disease. Arch Intern Med. 1999;159(4):387-92.
There are 29 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Articles
Authors

Halis Yılmaz 0000-0003-0853-7139

Seda Arslan Özkul 0000-0001-9817-1876

Kübra Temel Aslan 0000-0003-0007-3843

Pemra Cöbek Ünalan 0000-0003-3446-7082

Çiğdem Apaydın Kaya 0000-0003-4786-6760

Publication Date October 29, 2024
Submission Date March 26, 2024
Acceptance Date August 7, 2024
Published in Issue Year 2024 Volume: 16 Issue: 3

Cite

APA Yılmaz, H., Arslan Özkul, S., Temel Aslan, K., Cöbek Ünalan, P., et al. (2024). Predictive Factors of Peripheral Arterial Disease in Home Care Patients. Konuralp Medical Journal, 16(3), 225-232. https://doi.org/10.18521/ktd.1439261
AMA Yılmaz H, Arslan Özkul S, Temel Aslan K, Cöbek Ünalan P, Apaydın Kaya Ç. Predictive Factors of Peripheral Arterial Disease in Home Care Patients. Konuralp Medical Journal. October 2024;16(3):225-232. doi:10.18521/ktd.1439261
Chicago Yılmaz, Halis, Seda Arslan Özkul, Kübra Temel Aslan, Pemra Cöbek Ünalan, and Çiğdem Apaydın Kaya. “Predictive Factors of Peripheral Arterial Disease in Home Care Patients”. Konuralp Medical Journal 16, no. 3 (October 2024): 225-32. https://doi.org/10.18521/ktd.1439261.
EndNote Yılmaz H, Arslan Özkul S, Temel Aslan K, Cöbek Ünalan P, Apaydın Kaya Ç (October 1, 2024) Predictive Factors of Peripheral Arterial Disease in Home Care Patients. Konuralp Medical Journal 16 3 225–232.
IEEE H. Yılmaz, S. Arslan Özkul, K. Temel Aslan, P. Cöbek Ünalan, and Ç. Apaydın Kaya, “Predictive Factors of Peripheral Arterial Disease in Home Care Patients”, Konuralp Medical Journal, vol. 16, no. 3, pp. 225–232, 2024, doi: 10.18521/ktd.1439261.
ISNAD Yılmaz, Halis et al. “Predictive Factors of Peripheral Arterial Disease in Home Care Patients”. Konuralp Medical Journal 16/3 (October 2024), 225-232. https://doi.org/10.18521/ktd.1439261.
JAMA Yılmaz H, Arslan Özkul S, Temel Aslan K, Cöbek Ünalan P, Apaydın Kaya Ç. Predictive Factors of Peripheral Arterial Disease in Home Care Patients. Konuralp Medical Journal. 2024;16:225–232.
MLA Yılmaz, Halis et al. “Predictive Factors of Peripheral Arterial Disease in Home Care Patients”. Konuralp Medical Journal, vol. 16, no. 3, 2024, pp. 225-32, doi:10.18521/ktd.1439261.
Vancouver Yılmaz H, Arslan Özkul S, Temel Aslan K, Cöbek Ünalan P, Apaydın Kaya Ç. Predictive Factors of Peripheral Arterial Disease in Home Care Patients. Konuralp Medical Journal. 2024;16(3):225-32.