Comparative analysis of the use of Edinburgh Claudication questionnaire and ankle brachial index in diagnosing peripheral artery disease among the elderly in South-South, Nigeria

Symptomatic and asymptomatic Peripheral Artery Disease (PAD) is a common occurrence in the elderly. Most patients experience functional decline due to claudication pains and are predisposed to higher risk of cardiovascular disease. PAD is a strong prognostic marker of systemic atherosclerosis in those aged 60 years and above, thus impacting negatively on their functionality and quality of life. Objective: To compare the accuracy of Edinburgh Claudication Questionnaire (ECQ) and Ankle Brachial Index (ABI) in the elderly with PAD. Methods: A cross sectional descriptive hospital-based study was carried out among 370 elderly patients attending a Tertiary Hospital from September to November 2017. A systematic random sampling technique was utilized in recruiting participants into this study and a structured questionnaire was used in collecting participants’ information. Information collected using questionnaire included socio-demographic characteristics, lifestyle variables, and medical history. The ABI and ECQ were used to assess for PAD among the Elderly. Data collected were Analysed using SPSS for window version 21 (SPSS Inc., Chicago, IL, USA) statistical package software. Results: The prevalence of PAD was 38.1% and 37.8% using ECQ and ABI technique respectively. The sensitivity and specificity were 47.1% and 67.4%, while the Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were 46.8% and 67.7% respectively. Conclusion: The ECQ was found to be a valid screening tool for PAD in low resource settings, even though ECQ missed out most of the respondents who actually had PAD, which were diagnosed with ABI. It is imperative that screening for PAD with clinical foot examination, ECQ and ABI where it is available, be done for early detection and prompt intervention.