Author/Editor		Mlačak, Blaž; Ivka, Branimir; Kapš, Rafko; Okrajšek, Renata
Title		15-letna umrljivost bolnikov s periferno arterijsko okluzivno boleznijo
Translated title		15-years mortality in patients with peripheral arterial occlusive disease
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 75, št. 3
Publication year		2006
Volume		str. 151-5
Language		slo
Abstract		Background The aim of this study was to assess the risk of total and cardiovascular mortality in older adults with a low ankle-brachial index (ABI) as a marker of peripheral arterial occlusive disease (PROD). Patients and The test group included 87 PAOD patients, 49 males and 38 females aged between 52 and methods 86. The control group consisted of 87 subjects without PAOD, who were comparable to the test group by age, sex and profession. PAOD were diagnosed in the lower extremities by means Doppler ultrasound (ABI was between 0.50 and 0.90). Participants were evaluated in the period of 15 years to determine cause of death. Total and cardiovascular disease mortality rates were assessed in relationship to cardiovascular risk factors and the presence of a low ABI. Chi-square test and survival analysis were used to assess the differences in mortality between test and control group. Results In subjects with PAOD, test group, total mortality rates was 71 (81.6%) and in control group 49 (56,3%). In the same time cardiovascular mortality in PAOD group was 55 (63.2%) and in control group 31 (35. 6%). A low ABI was related to an increased risk of total (p < 0.001) and cardiovascular mortality (p < 0.001). A mean survival time of the PAOD group in the observation period was 5. 4 years, while 8.7 years was a mean survival time in the group with normal ABI. The PAOD subgroup consisted of the individuals below 65 years of age had a mean survival time of 65 years in a 15 year period, where as a mean survival time of the normal ABI in the same age bracket was 12.8 years (p < 0.05). Conclusions A low ABI has a significantly great predictive value for a total and cardiovascular mortality. In case a decreased ABI is found, measures to retard further progress of atherosclerosis should be applied.
Summary		Izhodišča cilj raziskave je bil ugotoviti pomen gleženjskega indeksa (GI) kot napovednika povečane umrljivosti pri bolnikih s periferno arterisjko okluzivno boleznijo (PAOB). Metode Raziskali smo dve skupini preiskovancev. V testni skupini je bilo 87 bolnikov s PAOB med 52. in 86. letom starosti, od tega 49 moških in 38 žensk. Kontrolna skupina, ki je imela tudi 87 preiskovancev brez PAOB, je bila primerljiva s testno po starosti, .spolu in zahtevnosti poklica. Periferno arterijsko okluzivno bolezen na spodnjih udih, gleženjski indeks je bil 0,50 do 0,90, smo ugotavljali z merjenjem sistoličnega krvnega tlaka s pomočjo ultrazvoč nega doplerskega detektorja. Pri preiskovancih obeh skupin smo spremljali splošno in srč no-žilno umrljivost v 15-letnem obdobju v povezavi z dejavniki tveganja za aterosklerozo in s prisotnostjo znižanega gleženjskega indeksa. Za oceno razlike v umrljivosti med test no in kontrolno skupino smo uporabili hi-kvadratni test in analizo preživetja. Rezultati V skupini bolnikov s PAOB, testna skupina, je imela v 15-letnem obdobju splošno umrljivost 71(81, 6%), medtem ko je v kontrolni skupini znašala 49 (56,3%). Hkrati je bila srčnožilna umrljivost v testni skupini 55 (63,2%) in v kontrolni skupini 31(35, 6%). Preiskovanci s PAOB so imeli pomembno višjo splošno (p < 0, 001) in srčno žilno umrljivost (p < 0, 001). Povprečni čas preživetja v opazovanem obdobju v skupini s PAOB je znašal 5,4 leta, med tem ko je v skupini z normalnim GI znašal 8, 7 leta. V podskupini pod 65. letom starosti je bil povprečni čas preživetja v 15-letnem obdobju pri skupini s PAOB 6,5 leta, medtem ko je v skupini z normalnim GI znašal 12, 8 leta (p < 0, 05). Zaključki Znižani gleženjski indeks je močan napovednik splošne in srčno žilne umrljivosti. Pri osebah z ugotovljeno znižano vrednostjo GI moramo izvajati ukrepe za preprečevanje napredovanja aterosklerotičnih sprememb.
Descriptors		ARTERIAL OCCLUSIVE DISEASES BLOOD PRESSURE ANKLE