Paris B E, Libow L S, Halperin J L, Mulvihill M N
Jewish Home and Hospital for Aged, New York, New York.
J Am Geriatr Soc. 1988 Jul;36(7):607-12. doi: 10.1111/j.1532-5415.1988.tb06154.x.
To assess the utility of bedside diagnostic measures to detect prognostically significant peripheral vascular disease, we examined 60 nursing home residents by physical examination, Doppler sphygmomamometry and pneumatic oscillometry, and recorded the clinical history. Eighty-eight percent of the cases had tibial/brachial arterial systolic pressure indices below 0.95, the lower limit traditionally considered normal. Yet, no more than 5% of the patients carried a previous diagnosis of peripheral vascular disease or had intermittent claudication, leg ulcers or gangrene. Approximately half of the patients had tibial/brachial pressure indices less than 0.7, and one year later in these cases, there was significantly greater morbidity and nearly twice the mortality of patients with less severe disease. We conclude that simple bedside diagnostic tests of arterial disease used in this study discloses a high prevalence of disease in institutionalized elderly patients and identifies a group at particular risk for morbid complications.
为评估床边诊断措施在检测具有预后意义的外周血管疾病方面的效用，我们通过体格检查、多普勒血压测量法和气动示波法对60名疗养院居民进行了检查，并记录了临床病史。88%的病例胫/肱动脉收缩压指数低于0.95，这是传统上认为正常的下限。然而，既往诊断为外周血管疾病或有间歇性跛行、腿部溃疡或坏疽的患者不超过5%。约一半患者的胫/肱压力指数小于0.7，一年后，这些病例的发病率显著更高，病情较轻患者的死亡率几乎是其两倍。我们得出结论，本研究中使用的简单床边动脉疾病诊断测试显示，在机构化老年患者中疾病患病率很高，并识别出一组有发生病态并发症特殊风险的人群。
