Coni N K
Postgrad Med J. 1985 Dec;61(722):1049-53. doi: 10.1136/pgmj.61.722.1049.
One hundred and twenty four elderly patients with peripheral vascular disease were seen by a geriatrician over a period of just under 4 years. Half of them presented with critical ischaemia and had not been previously known to have peripheral vascular disease. Two-thirds were shown to have bilateral disease; 14.5% of the series developed manifestations of the condition during the course of acute systemic illnesses and in 5 cases this was almost certainly, and in several more probably, due to haemodynamic crises. A third were dead within 3 months and so far a further 18.5% are known to have died within 2 y of first encounter. Of those who survived 3 months, at least 37% required treatment for persistent rest pain or had skin ulceration or necrosis, or had developed gangrene or come to amputation. Only 5 patients, after investigation, underwent successful limb salvage procedures. Peripheral vascular disease in old people is common, is likely to continue to be so, carries a dismal prognosis, and appears on the evidence presented here to be under-suspected until an advanced stage in the disease. Those dealing with the aged must be constantly on the alert for it since it calls for scrupulous care of the feet and for especial vigilance during acute systemic illness.
在近4年的时间里，一位老年病科医生诊治了124例患有周围血管疾病的老年患者。其中一半患者表现为严重缺血，且之前并不知晓患有周围血管疾病。三分之二的患者显示为双侧病变；该系列中有14.5%的患者在急性全身性疾病过程中出现了病情表现，在5例患者中这几乎肯定是，在另外几例中很可能是由于血流动力学危机所致。三分之一的患者在3个月内死亡，到目前为止，已知另有18.5%的患者在首次就诊后2年内死亡。在存活3个月的患者中，至少37%的患者需要治疗持续性静息痛、皮肤溃疡或坏死，或已发生坏疽或接受截肢手术。经过检查，只有5例患者成功接受了保肢手术。老年人的周围血管疾病很常见，而且可能会继续如此，预后不佳，并且从这里提供的证据来看，在疾病晚期之前往往未被充分怀疑。处理老年患者的人员必须时刻警惕这种疾病，因为它需要对足部进行细致护理，并在急性全身性疾病期间格外警惕。
