One simple claudication question as first step in Peripheral Arterial Disease (PAD) screening: A meta-analysis of the association with reduced Ankle Brachial Index (ABI) in 27,945 subjects

English version

Autoři: Arne Georg Kieback ^aff001; Christine Espinola-Klein ^aff002; Claudia Lamina ^aff003; Susanne Moebus ^aff004; Daniel Tiller ^aff005; Roberto Lorbeer ^aff006; Andreas Schulz ^aff007; Christa Meisinger ^aff008; Daniel Medenwald ^aff005; Raimund Erbel ^aff004; Alexander Kluttig ^aff005; Philipp S. Wild ^aff010; Florian Kronenberg ^aff003; Knut Kröger ^aff013; Till Ittermann ^aff014; Marcus Dörr ^aff015
Působiště autorů: Kantonsspital Aarau- Medizinische Universitätsklinik, Angiologie, Aarau, Switzerland ^aff001; University Medicine Mainz—Department of Angiology, Mainz, Germany ^aff002; Medical University of Innsbruck—Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Innsbruck, Austria ^aff003; Universitätsklinikum Essen (AöR), Institut für Medizinische Informatik, Biometrie und Epidemiologie (IMIBE), Essen, Germany ^aff004; Martin-Luther-University Halle-Wittenberg—Institute of Medical Epidemiology, Biostatistics and Informatics, Halle (Saale), Germany ^aff005; Ludwig Maximilian University Hospital—Department of Clinical Radiology, Munich, Germany ^aff006; University Medical Center of the Johannes Gutenberg-University Mainz, Center for Cardiology I, Mainz, Germany ^aff007; Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH)—Institute of Epidemiology II, Neuherberg, Germany ^aff008; Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T Augsburg Augsburg, Germany ^aff009; University Medical Center of the Johannes Gutenberg-University Mainz, Preventive Cardiology and Preventive Medicine, Center for Cardiology, Mainz, Germany ^aff010; University Medical Center of the Johannes Gutenberg-University Mainz, Center for Thrombosis and Hemostasis (CTH), Mainz, Germany ^aff011; DZHK (German Center for Cardiovascular Research), partner site RhineMain, Mainz, Germany ^aff012; Helios Klinikum Krefeld—Klinik für Gefäßmedizin, Krefeld, Germany ^aff013; University Medicine Greifswald, Institute for Community Medicine, Greifswald, Germany ^aff014; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany ^aff015; University Medicine Greifswald, Department of Internal Medicine B, Greifswald, Germany ^aff016
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0224608

Souhrn

Purpose and methods

A meta-analysis using data from seven German population-based cohorts was performed by the German Epidemiological consortium of Peripheral Arterial Disease (GEPArD) to investigate whether one question about claudication is more efficient for PAD screening than established questionnaires. Claudication was defined on the basis of the answer to one question asking for pain in the leg during normal walking. This simple question was compared with established questionnaires, including the Edinburgh questionnaire. The associations of claudication with continuous ABI values and decreased ABI were analyzed by linear and logistic regression analysis, respectively. The results of the studies were pooled in a random effect meta-analysis, which included data from 27,945 individuals (14,052 women, age range 20–84 years).

Results

Meta-analysis revealed a significant negative association between claudication and ABI, which was stronger in men (β = -0.07; 95%CI -0.10, -0.04) than in women (β = -0.02; 95%CI -0.02, -0.01). Likewise, the presence of claudication symptoms was related to an increased odds of a decreased ABI in both men (Odds ratio = 5.40; 95%CI 4.20, 6.96) and women (Odds ratio = 1.99; 95%CI 1.58, 2.51).

Conclusions

Asking only one question about claudication was able to identify many individuals with a high likelihood of a reduced ABI with markedly higher sensitivity and only slightly reduced specificity compared to more complex questionnaires. At least in men, this question should be established as first screening step.

Klíčová slova:

Death rates – Physicians – General practitioners – Questionnaires – Walking – Peripheral vascular disease

Zdroje

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