ABSTRACT
OBJECTIVE: Peripheral artery disease (PAD) identifies individuals at high risk for future cardiovascular disease (CVD) warranting aggressive risk reduction therapies. PAD can be diagnosed noninvasively by calculating the ankle brachial index (ABI), a ratio of ankle and arm blood pressures. We examined the existing various methods of calculating ABI and the resulting estimates of PAD prevalence. METHODS: We analyzed data from three National Health and Nutrition Examination Surveys. PAD prevalence using three different methods of calculating ABI was determined in 5,376 participants, aged > or =40 years without prior history of CVD. ABI was defined as an ankle brachial index of less than 0.9. Statistical analysis was performed using SPSS V15.0. RESULTS: PAD prevalence among asymptomatic adults without CVD increased significantly during the 6-year time period (1999-2004), regardless of the method used for determining ABI. However, across the National Health and Nutrition Examination Survey assessments, ABI method significantly affected calculated PAD prevalence. Differences in calculated PAD prevalence correspond to approximately 2.2 million persons who would be reclassified as having or not having PAD. CONCLUSION: The calculated prevalence of asymptomatic PAD varies significantly by the ABI method used. Further study is required to determine the most accurate method of performing ABI.
Subject(s)
Ankle/blood supply , Blood Pressure Determination , Blood Pressure , Brachial Artery/physiopathology , Peripheral Vascular Diseases/diagnosis , Adult , Aged , Cardiovascular Diseases/etiology , Cardiovascular Diseases/physiopathology , Female , Health Surveys , Humans , Male , Middle Aged , Nutrition Surveys , Peripheral Vascular Diseases/complications , Peripheral Vascular Diseases/epidemiology , Peripheral Vascular Diseases/physiopathology , Predictive Value of Tests , Prevalence , Reproducibility of Results , Risk Assessment , Time Factors , United States/epidemiologyABSTRACT
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most frequently isolated bacteria in wound cultures. MRSA has been linked to lengthened wound healing times, an increase in adverse postoperative outcomes, and mortality. This study investigated the incidence of MRSA in lower extremity wounds and examined outcomes associated with MRSA-infected wounds versus non-MRSA-infected wounds. A retrospective study was conducted. Patients with MRSA-infected wounds were compared with those with uninfected wounds in a 1:2 ratio. Demographics, infection, and stay information were collected. Data were analyzed using SPSS 15.0. 51 patients were included (17 with MRSA and 34 without MRSA). Patients with MRSA had increased lengths of stay and a higher incidence of adverse postoperative outcomes compared with non-MRSA patients. An MRSA infection adversely affects a patient's hospital course. Preoperative screening for MRSA and postoperative surveillance should be considered to prevent and eliminate the spread of this virulent bacterium.
