Absence of Preceding Intermittent Claudication and its Associated Clinical Freatures in Patients with Critical Limb Ischemia
Absence of Preceding Intermittent Claudication and its Associated Clinical Freatures in Patients with Critical Limb Ischemia
复制标题
DOI：
10.5551/jat.28217
复制
发表时间：
2015-01-01
影响因子：
4.4
通讯作者：
Azuma, Nobuyoshi
中科院分区：
文献类型：
--
作者：
Takahara, Mitsuyoshi;Iida, Osamu;Azuma, Nobuyoshi
目的：目前的研究调查如何普遍缺乏间歇性跛行的既往病史将在严重肢体缺血（CLI）的患者，并检查相关的临床features.Methods：我们使用了一个数据库的559名日本CLI患者参加了一个多中心的前瞻性研究。在登记时调查CLI发作前的间歇性跛行病史。采用Clopper-Pearson方法计算其患病率的95%置信区间（CI）。Logistic回归分析进行评估的临床特征和先前的间歇性claudiation.Results的情况下之间的关联：研究对象是73 +/- 10岁，67%是男性。82%的患者发生组织缺损。既往无间歇性跛行的患病率为50% [95% CI：46-55%]。在多变量logistic回归分析中，卧床状态、糖尿病和定期透析与既往无间歇性跛行病史显著独立相关（所有p < 0.05）。事实上，这些特征的存在与缺乏病史的患病率较高相关。定期透析，但不卧床状态或糖尿病，失去了其统计学意义后，进一步调整孤立的upperoplateal病变的存在，而孤立的upperoplateal病变本身的存在显着相关，缺乏先前的间歇性claudiation.Conclusions：没有间歇性跛行的病史是普遍的CLI患者。卧床状态、糖尿病和定期透析的患者更可能缺乏间歇性跛行的既往病史。
Aim: The current study investigated how prevalent the absence of a prior history of intermittent claudication would be in patients with critical limb ischemia (CLI) and examined the associated clinical features.Methods: We used a database of 559 Japanese CLI patients participating in a multicenter prospective study. A history of intermittent claudication prior to CLI onset was surveyed at registration. The 95% confidence interval (CI) of its prevalence was calculated using the Clopper-Pearson method. Logistic regression analysis was performed to assess the association between the clinical features and the absence of preceding intermittent claudication.Results: The study subjects were 73 +/- 10 years old and 67% were male. Tissue loss occurred in 82% of this population. The prevalence of the absence of prior intermittent claudication was 50% [95% CI: 46-55%]. In multivariate logistic regression analysis, a non-ambulatory status, diabetes mellitus, and regular dialysis were significantly and independently associated with the lack of a prior history of intermittent claudication (all p < 0.05). Indeed, the presence of these features was associated with a higher prevalence of the lack of the history. Regular dialysis, but not non-ambulatory status or diabetes mellitus, lost its statistical significance after further adjustment for the presence of isolated infrapopliteal lesions, whereas the presence of isolated infrapopliteal lesions itself was significantly associated with a lack of prior intermittent claudication.Conclusions: The absence of a prior history of intermittent claudication was prevalent in CLI patients. Patients with a non-ambulatory status, diabetes mellitus, and regular dialysis were more likely to lack a prior history of intermittent claudication.