Is ankle/arm pressure predictive for cardiovascular mortality in older patients living in nursing homes?
OBJECTIVE
To identify whether Ankle/Arm Index (AAI) is a predictive factor for cardiovascular mortality in institutionalised elderly.


METHODS



METHODS
longitudinal descriptive study.


METHODS
2 large nursing homes in Turin, Italy.


METHODS
418 dependent elderly (83 males, 335 females, mean age 83.7+/-8.5 y, range 55-102) living in the nursing homes.


METHODS
the prevalence of peripheral arterial disease (PAD) was evaluated using a Doppler Ultrasound measurement of AAI (Ankle/Arm blood pressure Index). Death causes according to ICD-9-CM were ascertained on patient's clinical records.


RESULTS
Diagnosis of PAD was made in 122 subjects (29.2%) with AAI <0.90. After a 3 year follow-up 203 patients (48.6%) died. The presence of PAD was not related to total mortality or to mortality for ischemic heart disease (IHD), cerebrovascular disease or other causes. IHD mortality was significantly and independently related to low haemoglobin values, previous cerebrovascular disease, polypharmacy and poor mobility conditions.


CONCLUSIONS
The prevalence of PAD is high in nursing home residents. AAI is not predictive for IHD mortality in this population. In very frail elderly traditional risk factors and PAD are less important predictors of death compared to poor functional status, nutritional factors and previous cardiovascular disease.
Zanocchi
M
M
Geriatric Section, Department of Medical and Surgical Disciplines, University of Turin, Turin, Italy. mzanocc@tin.it
Ponzetto
M
M
Scarafiotti
C
C
Maero
B
B
Giona
E
E
Francisetti
F
F
Nicola
E
E
Corsinovi
L
L
Amati
D
D
Fabris
F
F
D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000098:blood supply*; D001132:Arm / Q000098:blood supply*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009735:Nursing Homes; D011379:Prognosis