Background: Symptomatic and asymptomatic peripheral arterial disease (PAD) are important predictors of cardiovascular and cerebrovascular morbidity and mortality. Screening for PAD in the emergency department (ED) could facilitate early case detection and intervention. However, the prevalence and risk factors of PAD among the ED population remain undocumented, both internationally and in Australia.
Aims: (1) To determine the prevalence of symptomatic and asymptomatic PAD in ED patients aged 50 years or more and (2) to identify the clinical and demographic factors associated with PAD in ED patients aged 50 years or more.
Methods: A prospective cross-sectional survey was conducted in the ED at St. Vincent’s Hospital Melbourne. The main outcome was prevalence of PAD ( ankle brachial index < 0.9 in either leg). Participants were administered a demographic and clinical history questionnaire, the San Diego Claudication Questionnaire (SDCQ), the Intermittent Claudication Questionnaire (ICQ) and the Kessler Psychological Distress Scale (K10). Participants with a positive diagnosis of PAD were referred for further management and followed up by telephone interviews one month after ED discharge.
Results: Of 330 participants, the overall PAD prevalence was 11.0%. The prevalence of symptomatic and asymptomatic PAD were 4.5% and 6.4%, respectively. Risk factors included age, being widowed, family history of thrombosis, history of eye disease, heart disease, diabetes, vascular disease, hypercholesterolaemia, and various maedicaitons.
Conclusion: PAD is relatively common among the older ED population and is associated with risk factors similar to other atherosclerotic diseases, some of which are manageable through lifestyle or medical interventions.