Role of an intermittent claudication questionnaire for the diagnosis of PAD in ambulatory patients with type 2 diabetes.
Role of an intermittent claudication questionnaire for the diagnosis of PAD in ambulatory patients with type 2 diabetes.
复制标题
间歇性跛行问卷在 2 型糖尿病门诊患者 PAD 诊断中的作用。
DOI：
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发表时间：
2013
影响因子：
1.4
通讯作者：
Pedro Valdivielso
中科院分区：
文献类型：
--
作者：
J. Mancera;A. Rodríguez;M. AngelSánchez;M. Sánchez;F. Paniagua;A. Hidalgo;Pedro Valdivielso
目的
AIM
In epidemiological studies, peripheral arterial disease is assessed by the measurement of the ankle/brachial index (ABI), thus enabling detection of asymptomatic disease. Our aim was to evaluate the diagnostic accuracy of a validated questionnaire on intermittent claudication for peripheral arterial disease in a clinical setting.
METHODS
We administered the Edinburgh questionnaire on intermittent claudication and measured ABI using a portable Doppler in 456 outpatients with type 2 diabetes. Subjects with intermittent claudication and an ABI above 0.9 were examined with color Doppler ultrasound imaging. Peripheral arterial disease was considered to be present when the ABI was <0.9 or the color Doppler arterial waveform was monophasic.
RESULTS
Thirty-five (7.6%) of the 456 patients had intermittent claudication. Of these, 22 (63%) had an ABI <0.9 and the remaining 13 (37%) had an ABI >0.9. Of these latter, 12 were reexamined and 3 (25%) were found to have monophasic waveforms in color Doppler, thus being diagnosed with peripheral arterial disease. The overall accuracy of intermittent claudication for peripheral arterial disease was 75% (95% CI, 71-79).
CONCLUSION
Among patients with type 2 diabetes, a normal ABI does not rule out peripheral arterial disease; the use of an intermittent claudication questionnaire is able to identify correctly the disease in 3 out of 4 patients with diabetes. Our results suggest incorporating the intermittent claudication questionnaire into the general consultation instead of the general screening of the ABI.