确定PROMIS在外周动脉疾病重血管化后改善身体功能的最小临床重要差异
Teryn A Holeman1,2, Benjamin S Brooke1,2, Julie B Hales1
1University of Utah, School of Medicine, Salt Lake City, UT. USA.
Advances in patient-reported outcomes
|August 6, 2025
概括
患者报告的身体功能 (PROMIS-PF) 增加5个点意味着对外围动脉疾病 (PAD) 的重血管化后有意义的改善. 基线分数和年龄影响功能增长,而不仅仅是技术手术成功.
科学领域:
- 血管外科 血管外科
- 患者报告的结果
- 医疗保健服务研究 医疗服务研究
背景情况:
- 周围动脉疾病 (PAD) 影响身体功能,重血管化旨在改善它.
- 定义一个有意义的身体功能改善的临床值,对于患者的护理至关重要.
- 目前的理解缺乏一个明确的定义临床上显著的功能收益后下肢再血管化.
研究的目的:
- 在PAD患者下肢再血管化后,为患者报告的身体功能 (PROMIS-PF) 定义最小临床重要差异 (MCID).
- 确定预测实现这个定义的功能改进值的因素.
- 评估技术复血管化成功与功能结果之间的关系.
主要方法:
- 成年PAD患者接受选择性再血管化 (2016-2023) 的回顾性队列分析,使用PROMIS-PF得分.
- 使用基于和分布的方法来确定PROMIS-PF的MCID.
- 采用LASSO回归和通用线性混合模型来识别到达MCID的预测因素.
主要成果:
- 在PROMIS-PF中5个点的变化被确定为MCID,40%的患者实现了这种改善.
- 较高的基线PROMIS-PF得分和年龄较大与满足MCID的可能性较低有关.
- 脚-手臂指数 (ABI) 的改善并不总是预测实现功能性MCID.
结论:
- 对于PAD来说,PROMIS-PF的5个点改善是一个有意义的后回血化结果.
- 功能改善受患者的基线功能和年龄的影响,而不仅仅是技术手术的成功.
- 改善的ABI并不能保证患者报告的身体功能的相应有意义的改善.
相关概念视频
01:27Peripheral Artery Disease III: Interprofessional Care
29
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
29
01:26Peripheral Artery Disease IV: Nursing Management
44
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
44
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
35
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
35
01:23Peripheral Artery Disease V: Postoperative Nursing Management
25
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
25
01:30Peripheral Artery Disease I: Introduction
33
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
33
01:27Assessment of the Cardiovascular System III: Palpation
496
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
496