Perfil de los pacientes con claudicación intermitente en España. Estudio VITAL / Profile of patients with intermittent claudication in Spain. The VITAL Study

RESUMEN

Introducción: La claudicación intermitente ( CI ) es frecuente entre la población occidental, incluida la española; sin embargo, sus características no son bien conocidas. El objetivo del estudio es conocer el perfil de los pacientes españoles con CI. Material y métodos: Estudio prospectivo, observacional, transversal, multicéntrico y no aleatorizado sobre 1.641 claudicantes, divididos en 2 grupos a) angiología y cirugía vascular (ACV) (n = 920), y b) atención primaria (MAP) (n = 721). Los pacientes fueron sometidos a un cuaderno de recogida de datos (CRD), analítica, índice tobillo/brazo (ITB), cuestionario Walking Impairment Questionaire (WIQ) y cuestionario europeo de calidad de vida (EQ-5D). Resultados: Fueron varones el 75,3%, de 68,3 ± 9,4 años, destacando sobremanera el elevado número de factores de riesgo cardiovascular y enfermedades asociadas (fundamentalmente cardiacas), más frecuente en el grupo ACV. El ITB de la serie 0,66 ± 0,19, inferior en grupo ACV (p = 0,001). Los porcentajes WIQ fueron daños motores (48,57 ± 20,12), distancia (35,09 ± 25,73), velocidad (36,18 ± 22,83) y escaleras (41,76 ± 27,62), peores en lo relativo a los daños motores (p < 0,001) y distancia (p = 0,007) en el grupo ACV. La puntuación EQ-5D fue 0,57 ± 0,21, sin diferencias entre grupos. Conclusiones: Los pacientes españoles con CI presentan 3 características alto riesgo cardiovascular, limitada capacidad para el ejercicio e importante reducción de la calidad de vida. Existen diferencias entre grupos, dado que los ACV tratan pacientes con enfermedad más avanzada (AU)

ABSTRACT

Introduction: Intermittent claudication (IC) is a very prevalent condition in Western countries including the population of Spain. However, little is known about the medical profile and quality of life (QoL) of the IC in Spain. Aim: To determine the clinical characteristics and QoL in a large sample of Spanish patients with IC. Material and methods: An observational, prospective, cross sectional and multicentre study was performed between October 2010 and January 2011, with 625 investigators recruiting 1,641 consecutive patients with claudication. The sample was divided into two groups a) patients evaluated by vascular surgeons (VS) (n = 920), and b) patients evaluated by general practitioners (GP) (n = 721). Demographical and clinical characteristics, analytical findings (glucose levels and lipid metabolism) and the Ankle-Brachial Index (ABI) were recorded. Each patient included in the study also filled in two questionnaires the Walking impairment Questionnaire (WIQ) and the European Quality of Life-5 Dimensions (EQ-5D). Results: The population mean age was 68.3 ± 9.4 years; in 75.3% of the cases the patients were males. The presence of risk cardiovascular factors (49.5% of diabetes; 76.9% of hypertension and 65.3% of dyslipemia) and comorbid conditions (in particular, cardiovascular diseases) were high. The mean ABI of the series was 0.66 ± 0.19. Patients in the VS group had more severe IC than patients from GP Group (ABI = 0.63 vs ABI = 0.71, P<0.001). WIQ scores obtained were a) walking distance = 35.09 ± 25.73; b) walking speed = 36.18 ± 22.83, and c) stair-climbing capacity = 41.76 ± 27.62. We only found significant statistical differences in walking distance between the VS Group and GP Group. The global EQ-5D score was 0,57 ± 0,21. No significant differences were observed between the VS and GP groups (AU)