Correlation between Patient-Reported Symptoms and Ankle-Brachial Index after Revascularization for Peripheral Arterial Disease.

Hyung Je,Kyoung Cho,Yong Park,John Spertus,Bo Kim,Jae Jang

doi:10.3390/ijms160511355

Abstract

Improvement in quality of life (QoL) is a primary treatment goal for patients with peripheral arterial disease (PAD). The current study aimed to quantify improvement in the health status of PAD patients following peripheral revascularization using the peripheral artery questionnaire (PAQ) and ankle-brachial index (ABI), and to evaluate possible correlation between the two methods. The PAQ and ABI were assessed in 149 symptomatic PAD patients before, and three months after peripheral revascularization. Mean PAQ summary scores improved significantly three months after revascularization (+49.3 ± 15 points, p < 0.001). PAQ scores relating to patient symptoms showed the largest improvement following revascularization. The smallest increases were seen in reported treatment satisfaction (all p’s < 0.001). As expected the ABI of treated limbs showed significant improvement post-revascularization (p < 0.001). ABI after revascularization correlated with patient-reported changes in the physical function and QoL domains of the PAQ. Twenty-two percent of PAD patients were identified as having a poor response to revascularization (increase in ABI < 0.15). Interestingly, poor responders reported improvement in symptoms on the PAQ, although this was less marked than in patients with an increase in ABI > 0.15 following revascularization. In conclusion, data from the current study suggest a significant correlation between improvement in patient-reported outcomes assessed by PAQ and ABI in symptomatic PAD patients undergoing peripheral revascularization.

Highlights

Patients with peripheral arterial disease (PAD) have greater functional impairment and faster rates of functional decline than the healthy population [1]
The Peripheral Artery Questionnaire (PAQ) was developed to measure the health status of PAD patients based on their symptoms, functional status, and quality of life (QoL) [5]
The aim of this study was to quantify improvement in the health status of symptomatic PAD patients undergoing peripheral revascularization via ankle-brachial index (ABI) and PAQ, and to investigate whether patient-reported symptom outcomes correlated with medically measured outcomes

Summary

Introduction

Patients with peripheral arterial disease (PAD) have greater functional impairment and faster rates of functional decline than the healthy population [1]. The selection of optimal medical therapy and revascularization procedure depends on quantifying PAD patients’ health status, since these interventions are primarily intended to improve symptoms, functional status, and quality of life (QoL) [3]. The ankle-brachial index (ABI) has been used as a sensitive, valuable, and cost-effective outcome measure and screening tool for PAD. The rates of lower extremity revascularization and related medical costs are increasing and the application of direct, patient-centered outcome assessments is necessary to quantify treatment success. The Peripheral Artery Questionnaire (PAQ) was developed to measure the health status of PAD patients based on their symptoms, functional status, and QoL [5]. We have previously translated and validated a Korean version of the PAQ in Korean PAD patients and demonstrated that

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