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在以患者为中心的外周动脉疾病治疗实践相关结局研究(PORTRAIT)注册研究中,健康状况与社会人口学、临床和治疗差异之间的关联。

Association between health status and sociodemographic, clinical and treatment disparities in the Patient-centered Outcomes Related to TReatment Practices in Peripheral Arterial Disease: Investigating Trajectories (PORTRAIT) registry.

机构信息

1 Warren Alpert Medical School at Brown University, Lifespan Cardiovascular Institute, Providence, RI, USA.

2 Mid America Heart Institute of Saint Luke's Hospital and the University of Missouri-Kansas City, Kansas City, MO, USA.

出版信息

Vasc Med. 2018 Feb;23(1):32-38. doi: 10.1177/1358863X17747047. Epub 2018 Jan 17.

Abstract

Patients with peripheral artery disease (PAD) and intermittent claudication (IC) have impaired functional status and quality of life. However, little is known about which factors are associated with poorer health status at the time of initial presentation for PAD specialty care. Characterization of such features might provide insight into disparities that impact health status in this population. A total of 1258 patients from the United States, the Netherlands and Australia with new or worsened IC were enrolled at their first PAD specialty care visit between June 2011 and December 2015. The mean Peripheral Artery Questionnaire (PAQ) Summary Score (range 0-100), a disease-specific health status measure, was 49.2 ± 21.9. Hierarchical, multivariable linear regression was used to relate patient characteristics to baseline PAQ. Patient characteristics independently associated with poorer health status were age ( p < 0.001), female sex ( p < 0.001), not being married ( p = 0.02), economic burden (moderate/severe vs none, moderate/severe vs some; p = 0.03), difficulty getting care (moderate/severe vs none, moderate/severe vs some; p < 0.001), chronic lung disease ( p = 0.02), back pain ( p < 0.001), bilateral vs unilateral PAD ( p = 0.02), intermittent claudication severity (moderate vs mild, severe vs mild, p < 0.001), and lack of prior participation in an exercise program ( p = 0.005). Disparities in both vascular and non-vascular factors were associated with patients' health status at the time of presentation and should be addressed by all who care for patients with vascular disease.

摘要

患有外周动脉疾病 (PAD) 和间歇性跛行 (IC) 的患者的功能状态和生活质量受损。然而,对于哪些因素与 PAD 专科就诊时健康状况较差相关,目前知之甚少。对这些特征的描述可能有助于深入了解影响该人群健康状况的差异。2011 年 6 月至 2015 年 12 月期间,共有 1258 名来自美国、荷兰和澳大利亚的新诊断或恶化的 IC 患者在首次 PAD 专科就诊时入组。使用外周动脉问卷 (PAQ) 综合评分(范围 0-100)这一特定于疾病的健康状况衡量标准,平均评分为 49.2 ± 21.9。采用分层多变量线性回归将患者特征与基线 PAQ 相关联。与健康状况较差独立相关的患者特征包括年龄(p < 0.001)、女性(p < 0.001)、未婚(p = 0.02)、经济负担(中度/重度与无,中度/重度与部分;p = 0.03)、就医困难(中度/重度与无,中度/重度与部分;p < 0.001)、慢性肺部疾病(p = 0.02)、背痛(p < 0.001)、双侧与单侧 PAD(p = 0.02)、间歇性跛行严重程度(中度与轻度,重度与轻度;p < 0.001)和缺乏之前参加锻炼计划(p = 0.005)。血管和非血管因素的差异均与患者就诊时的健康状况相关,所有治疗血管疾病的医生都应予以关注。

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