The burden and characteristics of peripheral arterial disease in patients undergoing amputation in Korle Bu Teaching Hospital, Accra, Ghana

Abstract

SUMMARYBackground: To determine the prevalence of Peripheral Arterial Disease (PAD) and associated risk factors in patients undergoing amputation at the Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Objectives: A cross-sectional study of all patients undergoing lower extremity amputation at the Department of Surgery, KBTH. Materials: A coded questionnaire was used to ascertain risk factors for PAD. The Edinburgh Claudication Questionnaire was used to determine symptomatic PAD and a 5 mmHz hand held Summit® Doppler together with an Accoson® sphygmomanometer was used to determine PAD and its severity. Method: Clinical diagnosis of symptomatic PAD was made using a symptom-based questionnaire and signs of PAD determined by measuring the ankle brachial pressure index (ABPI) by means of a handheld Doppler and sphygmomanometer. Risk factors were determined using the coded questionnaire and related to the occurrence and severity of PAD. Results: The prevalence of PAD among recruited participants was 71%. Twenty-eight per cent of participants with PAD in the index limb also showed signs of PAD in the other limb. The diagnosis of PAD was made in 71%, using ABPI, and 13%, using ECQ. Twenty-seven per cent of patient with hypertension, seventeen per cent with diabetes and all patients with hypercholesterolemia were not on any form of medication. Conclusion: There is a high prevalence of PAD among patients undergoing lower extremity amputation at the KBTH. The majority of PAD patients presented with moderate to severe PAD. Instituting measures to identify and control risk factors of PAD may reduce this high burden.

Prevalence and associations of subclinical peripheral artery disease among patients with type 2 diabetes without clinical macrovascular disease

“…Prevalence rates of PAD as high as 70% has been reported in studies of patients with T2DM with severe diabetic foot disease including those referred for amputations or those with established coronary or CVD. [1819] Studies including newly diagnosed patients with diabetes and those without established vascular complications have reported lower prevalence rates of PAD ranging from 3–10%. [12]…”

Quality assessment and comparative analysis on the recommendations of current guidelines on the management of peripheral arterial disease: a systematic review protocol

“…1 Epidemiological data show that behind ischaemic heart disease and stroke, peripheral arterial disease (PAD) is the third most common atherosclerotic arterial disease. [2][3][4][5] Despite its significant contribution to morbidity and mortality globally, there had been a paucity in the number of randomised clinical trials and high-quality systematic reviews of randomised clinical trials on PAD with consequent low-quality recommendations in practical guidelines. Over time, the results of high-powered RCT have been published with others on the way, which we expect to influence the more recent clinical practice guidelines (CPGs).…”

Experiences Following Amputation among Amputees and Their Caregivers: An Exploratory Study in a Developing Country

“…For instance Atosona and Larbie (2019) focused on the prevalence and determinants of diabetic foot ulcers and lower extremity amputations in three selected tertiary hospitals. Also, Bediako-Bowan et al (2017) investigated the burden and characteristics of peripheral arterial disease in patients undergoing amputation in Korle Bu Teaching Hospital. Other studies like Buunaaim et al (2019) retrospectively examined the pattern of trauma-related amputations among children in Ghana.…”