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J Am Coll Cardiol. 2013 Apr 30;61(17):1820-9. doi: 10.1016/j.jacc.2013.01.060. Epub 2013 Feb 28.

Declining walking impairment questionnaire scores are associated with subsequent increased mortality in peripheral artery disease.

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  • 1Department of Medicine, The University of Chicago, Chicago, Illinois, USA.

Abstract

OBJECTIVES:

This study determined whether greater 2-year declines in Walking Impairment Questionnaire (WIQ) stair climbing, distance, or speed scores were associated with higher all-cause and cardiovascular disease (CVD) mortality among men and women with lower extremity peripheral artery disease (PAD).

BACKGROUND:

Associations of decline in the WIQ with mortality among people with PAD are unknown.

METHODS:

Participants were 442 men and women with PAD identified from Chicago area medical centers. The WIQ was completed at baseline and at 2-year follow-up. Cox proportional hazard models were used to assess associations across categories of 2-year changes in WIQ stair climbing, WIQ distance, and WIQ speed scores with subsequent all-cause and CVD mortality, adjusting for age, sex, race, ankle-brachial index, body mass index, smoking, comorbidities, and other covariates.

RESULTS:

One hundred twenty-three participants (27.8%) died during a median follow-up of 4.7 years after the 2-year change in WIQ score measurements. Forty-five participants died from CVD. Adjusting for covariates, participants with WIQ score declines ≥20.0 points had higher all-cause mortality (hazard ratio [HR]: 1.93, 95% confidence interval [CI]: 1.01 to 3.68 for WIQ stair climbing; HR: 2.34, 95% CI: 1.15 to 4.75 for WIQ distance; and HR: 3.55, 95% CI: 1.57 to 8.04 for WIQ speed, respectively) compared with participants with ≥20.0 point improvement in each of the corresponding WIQ categories. Participants with ≥20.0 point declines in the WIQ distance score had higher CVD mortality (HR: 4.56, 95% CI: 1.30 to 16.01) compared with those with ≥20.0 point improvement in the WIQ distance score.

CONCLUSIONS:

Patients with PAD who experienced ≥20.0 point declines in the WIQ stair climbing, distance, and speed scores had a higher rate of all-cause mortality compared with those with less declines in each WIQ score.

Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PMID:
23500321
[PubMed - indexed for MEDLINE]
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