McDermott Mary M, Guralnik Jack M, Tian Lu, Ferrucci Luigi, Liu Kiang, Liao Yihua, Criqui Michael H
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
J Am Coll Cardiol. 2007 Sep 4;50(10):974-82. doi: 10.1016/j.jacc.2007.05.030. Epub 2007 Aug 20.
We compared rates of mobility loss among persons with versus without peripheral arterial disease (PAD). Associations between baseline functional performance and mobility loss in persons with and without PAD were studied.
Persons with PAD have poorer functional performance than persons without PAD. The prognostic value of poorer performance in persons with PAD is unknown.
Participants were 398 persons with and 240 without PAD who were free of mobility impairment at baseline. Participants were followed for a median of 50 months. Baseline measures included the 6-min walk and the Short Physical Performance Battery score. Mobility status, assessed annually, was defined as the self-reported loss of the ability to walk one-quarter mile or walk up and down one flight of stairs without assistance.
Adjusting for age and gender, we found that PAD participants had a greater rate of mobility loss than persons without PAD (hazard ratio [HR] 1.63; 95% confidence interval [CI] 1.03 to 2.56). This difference was not statistically significant after additional adjustment for baseline performance. Among PAD participants, risk of mobility loss in the lowest versus the 2 highest quartiles of baseline performance were as follows: HR 9.65 (95% CI 3.35 to 27.77, p < 0.001) for the 6-min walk and HR 12.84 (95% CI 4.64 to 35.55, p < 0.001) for the Short Physical Performance Battery when adjusting for confounders.
Persons with PAD experience greater mobility loss than persons without PAD. This association was explained by poorer baseline functional performance among participants with PAD. Poorer lower extremity performance predicts increased mobility loss in persons with and without PAD.
我们比较了患有与未患有外周动脉疾病(PAD)的人群中行动能力丧失的发生率。研究了有和没有PAD的人群中基线功能表现与行动能力丧失之间的关联。
患有PAD的人群比未患有PAD的人群功能表现更差。PAD患者中较差表现的预后价值尚不清楚。
参与者包括398名患有PAD和240名未患有PAD的人,他们在基线时没有行动障碍。对参与者进行了为期50个月的中位随访。基线测量包括6分钟步行试验和简短体能状况量表评分。每年评估的行动能力状态定义为自我报告的在无辅助情况下行走四分之一英里或上下一层楼梯的能力丧失。
在调整年龄和性别后,我们发现患有PAD的参与者行动能力丧失的发生率高于未患有PAD的人群(风险比[HR]为1.63;95%置信区间[CI]为1.03至2.56)。在对基线表现进行额外调整后,这种差异无统计学意义。在患有PAD的参与者中,基线表现处于最低四分位数与最高两个四分位数相比,行动能力丧失的风险如下:调整混杂因素后,6分钟步行试验的HR为9.65(95%CI为3.35至27.77,p<0.001),简短体能状况量表的HR为12.84(95%CI为4.64至35.55,p<0.001)。
患有PAD的人群比未患有PAD的人群行动能力丧失更多。这种关联可以通过患有PAD的参与者较差的基线功能表现来解释。下肢表现较差预示着有和没有PAD的人群行动能力丧失增加。