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13-03-2013 | Vascular medicine | Article

Questionnaire predicts peripheral artery disease mortality


Free abstract

medwireNews: Deterioration on the Walking Impairment Questionnaire (WIQ) predicts mortality in patients with peripheral artery disease (PAD), say researchers.

The association between walking ability and mortality in PAD patients is not new, having been shown using assessments such as the 6-minute walk test and 4-meter walking velocity.

But Mary McDermott (Northwestern University, Chicago, Illinois, USA) and team say that such tests are "objective measures that require dedicated time and space in the clinical setting, whereas the WIQ can be self-administered by PAD patients and is not time- or labor-intensive."

However, they note that "applying our results to clinical practice would require that physicians be prompted to re-administer the WIQ score two years after a baseline measure."

The team studied 442 participants of the Walking and Leg Circulation Study who had PAD and had completed the WIQ at baseline and 2 years later. During a median 4.7 years of follow up after second completion of the WIQ, 123 (27.8%) patients died, with 36.5% of these dying from cardiovascular disease.

There was a trend toward an increased risk for mortality across categories of change on the WIQ. For the WIQ stair-climbing domain, patients who had at least a 20-point decline in score had a 1.93-fold increased risk for dying relative to those with an improvement of at least 20 points; for the WIQ distance domain there was a corresponding 2.45-fold risk increase and for the WIQ speed domain there was a 3.55-fold increase in mortality risk.

These associations were independent of baseline variables including age, gender, race, ankle-brachial index (ABI), body mass index, smoking status, and WIQ score. But the associations were progressively attenuated after further accounting for the 2-year change in ABI, and the 2-year incidence of stroke, myocardial infarction, and angina.

"These findings suggest that progression of systemic cardiovascular disease may explain associations of change in WIQ domain scores with all-cause mortality," suggest McDermott et al in the Journal of the American College of Cardiology.

By Eleanor McDermid, Senior medwireNews Reporter

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