[Show abstract][Hide abstract] ABSTRACT: OBJECTIVES: We determined whether greater two-year declines in Walking Impairment Questionnaire (WIQ) stair climbing, distance, or speed scores, respectively, are 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 two-year follow-up. Cox proportional hazard models were used to assess associations across categories of two-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 (ABI), body mass index, smoking, comorbidities, and other covariates. RESULTS: 123 participants (27.8%) died during a median follow-up of 4.7 years after the two-year change in WIQ score measurements. Forty-five participants died from CVD. Adjusting for covariates, participants with WIQ score declines ≥ 20 points had higher all-cause mortality (HR = 1.93 [95% Confidence Interval (CI) 1.01 - 3.68 for WIQ stair climbing], HR = 2.34 [95% CI 1.15 - 4.75 for WIQ distance], and HR = 3.55 [95% CI 1.57 - 8.04 for WIQ speed], respectively) compared to 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 - 16.01]) compared to those with ≥ 20-point improvement in the WIQ distance score. CONCLUSIONS: Patients with PAD who experience ≥ 20 point declines in the WIQ stair climbing, distance and speed scores have a higher rate of all-cause mortality, compared to those with less declines in each WIQ score.
Preview · Article · Feb 2013 · Journal of the American College of Cardiology
[Show abstract][Hide abstract] ABSTRACT: The Walking Impairment Questionnaire (WIQ) measures self-reported walking distance, walking speed, and stair-climbing ability in men and women with lower extremity peripheral arterial disease (PAD). We determined whether poorer WIQ scores are associated with higher all-cause and cardiovascular disease (CVD) mortality in individuals with and without PAD.
We identified 1048 men and women with and without PAD from Chicago-area medical centers. Participants completed the WIQ at baseline and were monitored for a median of 4.5 years. Cox proportional hazards models were used to relate baseline WIQ scores with death, adjusting for age, sex, race, the ankle-brachial index (ABI), comorbidities, and other covariates.
During follow-up, 461 participants (44.0%) died, including 158 deaths from CVD. PAD participants in the lowest baseline quartile of the WIQ stair-climbing scores had higher all-cause mortality (hazard ratio, 1.70; 95% confidence interval, 1.08-2.66, P = .02) and higher CVD mortality (hazard ratio, 3.11; 95% confidence interval, 1.30-7.47, P = .01) compared with those with the highest baseline WIQ stair-climbing score. Among PAD participants, there were no significant associations of lower baseline WIQ distance or speed scores with rates of all-cause mortality (P = .20 and P = .07 for trend, respectively) or CVD mortality (P = .51 and P = .33 for trend, respectively). Among non-PAD participants there were no significant associations of lower baseline WIQ stair-climbing, distance, or speed score with rates of all-cause mortality (P = .94, P = .69, and P = .26, for trend, respectively) or CVD mortality (P = .28, P = .68, and P = .78, for trend, respectively).
Among participants with PAD, lower WIQ stair-climbing scores are associated with higher all-cause and CVD mortality, independently of the ABI and other covariates.
Preview · Article · Jun 2012 · Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter