Importance of factors determining the low health‐related quality of life in people presenting with a diabetic foot ulcer: the Eurodiale study

Siersma, Volkert; Thorsen, Hanne; Holstein, P.; Kars, Marleen; Apelqvist, Jan; Jude, Edward B.; Piaggesi, Alberto; Баккер, К.; Edmonds, M.; Jirkovská, Alexandra; Mauricio, Dı́dac; Tennvall, Gunnel Ragnarson; Reike, Heinrich; Spraul, Maximilian; Uccioli, Luigi; Urbančič, V.; Acker, Kristien Van; Baal, Jeff Van; Schaper, Nicolaas C.

doi:10.1111/dme.12254

Cited by 95 publications

(82 citation statements)

References 24 publications

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“…In unadjusted analyses, we found decreased healing for several EQ-5D domains. As reported elsewhere, all domains of HRQoL at baseline were affected by both patient characteristics, such as inability to stand or walk without help, and by ulcer-related factors, such as ulcer size or limb-threatening ischemia (3,4). These factors are also associated with ulcer healing, which may further explain why we did not observe an independent effect of HRQoL on healing after correction for these factors.…”

Section: Discussionsupporting

confidence: 59%

“…Already at the initial presentation in the foot clinic, DFU patients report severely hampered health-related quality of life (HRQoL) (4). Several studies have clearly shown that self-assessed health status is an independent predictor of mortality in a general population, beyond the numerous other risk factors known to be associated with increased mortality (5).…”

mentioning

confidence: 99%

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Health-Related Quality of Life Predicts Major Amputation and Death, but Not Healing, in People With Diabetes Presenting With Foot Ulcers: The Eurodiale Study

et al. 2014

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Low health-related quality of life (HRQoL) has been consistently reported to be associated with poor prognosis for a variety of health outcomes in various settings. We aimed to evaluate whether HRQoL in patients presenting with new diabetic foot ulcers (DFUs) has prognostic significance for ulcer healing, major amputation, and death. RESEARCH DESIGN AND METHODSWe followed 1,088 patients with new DFUs presenting for treatment at one of the 14 centers in 10 European countries participating in the Eurodiale (European Study Group on Diabetes and the Lower Extremity) study, prospectively until healing (76.9%), major amputation (4.6%), or death (6.4%) up to a maximum of 1 year. At baseline, patient and ulcer characteristics were recorded as well as EQ-5D, a standardized instrument consisting of five domains and a visual analog scale for use as a measure of HRQoL. The prognostic influence of the EQ-5D domains was evaluated in multivariable Cox regression analyses on the time-to-event data, adjusting for baseline clinical characteristics of the ulcer and comorbidities. RESULTSWhile predictive effects of HRQoL, adjusted for possible confounders, were absent for healing, decreased HRQoL, especially in the physical domains, was statistically significant for major amputation (mobility, self-care, usual activities) and death (self-care, usual activities, pain/discomfort). CONCLUSIONSLow HRQoL appears to be predictive for major amputation and death, but high HRQoL does not increase healing. Future studies into the influence of HRQoL on ulcer outcome are important in attempts to decrease treatment failure and mortality.

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Section: Discussionsupporting

confidence: 59%

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confidence: 99%

Health-Related Quality of Life Predicts Major Amputation and Death, but Not Healing, in People With Diabetes Presenting With Foot Ulcers: The Eurodiale Study

et al. 2014

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“…41, 47 Hopman et al 41 described that male patients with younger age, pain, problems with their mobility, or daily activities, as well as anxiety at their first visit, benefit the most from possible interventions regarding especially their mentally orientated QoL. Vice versa Hopman et al 41 concluded that vulnerable subgroups are those with pain, anxiety and depression at first visit.…”

Section: Depression and Limited Mobilitymentioning

confidence: 99%

Depression and quality of life in patients with chronic wounds: ways to measure their influence and their effect on daily life

Renner¹,

Erfurt‐Berge²

2017

CWCMR

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Depression is a very common comorbidity in patients with chronic wounds. At least 30% of those patients suffer from depressive symptoms or anxiety. To measure impairment on daily life, different quality of life (QoL) questionnaires can be used as well as specialized questionnaires to evaluate different levels of depression. In this review, we present some of the current measurement tools and effects of depression on QoL. Depression is often associated with wound duration, odor of wounds, and furthermore with pain and immobility. On the other hand, depression might reduce wound healing itself via psychoimmunological effects. QoL, in general, is reduced in patients with chronic wounds, but especially in the case of pain, immobility and older age, and sometimes independent to wound status (healed or active). Treating medical and health care personnel should establish depression and QoL questionnaires in daily practice and should consider the psychological health of their patients as part of their treatment.

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“…This complication almost affects 50% of patients and accounts for nearly 80% of all nontraumatic amputations of the lower limb [3,4]. The disease represents nearly 35% of all hospital admissions in diabetic specialized clinics [3].…”

Section: Introductionmentioning

confidence: 99%

Diabetic Foot Care: Knowledge and Practice

et al. 2016

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Importance of factors determining the low health‐related quality of life in people presenting with a diabetic foot ulcer: the Eurodiale study

Cited by 95 publications

References 24 publications

Health-Related Quality of Life Predicts Major Amputation and Death, but Not Healing, in People With Diabetes Presenting With Foot Ulcers: The Eurodiale Study

Health-Related Quality of Life Predicts Major Amputation and Death, but Not Healing, in People With Diabetes Presenting With Foot Ulcers: The Eurodiale Study

Depression and quality of life in patients with chronic wounds: ways to measure their influence and their effect on daily life

Diabetic Foot Care: Knowledge and Practice

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