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Peripheral vascular disease--the geriatrician's tale.

N K Coni

    Postgraduate Medical Journal
    |December 1, 1985
    PubMed
    Summary

    Peripheral vascular disease (PVD) is common in the elderly, often presenting late with poor outcomes. Early detection and foot care are crucial, especially during acute illnesses, to improve prognosis.

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    Area of Science:

    • Geriatrics
    • Vascular Surgery
    • Epidemiology

    Background:

    • Peripheral vascular disease (PVD) is a significant health concern in the elderly population.
    • Many elderly patients with PVD are diagnosed late, often during acute systemic illnesses.
    • PVD in older adults is frequently under-suspected until advanced stages.

    Purpose of the Study:

    • To investigate the prevalence, presentation, and prognosis of peripheral vascular disease in elderly patients.
    • To highlight the challenges in diagnosing and managing PVD in geriatric populations.
    • To emphasize the need for increased vigilance for PVD in the elderly.

    Main Methods:

    • Retrospective analysis of 124 elderly patients with peripheral vascular disease over nearly 4 years.
    • Inclusion of patients presenting with critical ischemia and those diagnosed during acute illnesses.
    • Documentation of disease laterality, progression, and treatment outcomes.

    Main Results:

    • Half of the patients presented with previously unknown critical ischemia.
    • Two-thirds had bilateral disease; 14.5% developed PVD manifestations during acute illnesses.
    • Mortality was high: 33% within 3 months, 18.5% within 2 years.
    • Among survivors, 37% experienced persistent pain, ulceration, necrosis, gangrene, or amputation.
    • Only 5 patients underwent successful limb salvage procedures.

    Conclusions:

    • Peripheral vascular disease in the elderly is common, often presents late, and carries a dismal prognosis.
    • Under-suspicion and delayed diagnosis contribute to poor outcomes in geriatric PVD.
    • Continuous vigilance for PVD, meticulous foot care, and heightened awareness during acute illnesses are essential for elderly patients.

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