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Ghana Medical Journal

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

Antoinette A. A. Bediako-Bowan, George O. Adjei, Joe N. Clegg-Lamptey, Simon B. Naaeder

Abstract


Background: 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 ofSurgery, 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.

Funding: Not declared

Keywords: Peripheral arterial disease, ABPI, Prevalence, Ghana, Amputation

Funding source: Authors funded the study




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