Quality of Life in Different Stages of Chronic Venous Insufficiency and Leg Ulcer

Abstract

Background: Chronic venous insufficiency (CVI) is a frequent disease, reaching from mild ankle edema to severe venous leg ulcer. Previous studies have focused on the quality of life (QoL) in patients with leg ulcer, but not in patients with early forms of CVI nor stagerelated differences. Objective: To assess the quality of life in patients with CVI stages I, II, IIIa and IIIb (venous leg ulcer). Patients and Methods: Survey in a representative sample. 324 consecutive patients with different stages of CVI of a unit for phlebology and chronic wounds in the University hospital Freiburg were asked to answer validated questionnaires. In a period of 12 months, complete data were obtained from 276 patients. QoL was assessed by the Nottingham Health Profile (NHP), a generic QoL instrument, and the Freiburg Quality of Life Assessment (FLQA), a disease-specific questionnaire. The emotional status was assessed using the Symptom Checklist (SCL-90 R). Results: Qol was increasingly impaired from CVI stage I to CVI stage IIIb in the following areas: Pain and other physical complaints, physical mobility, energy level, social life, everyday life and stress due to treatment. In patients with CVI I QoL was only reduced in terms of sleep disturbances; patients with CVI II were also impaired in everyday life, pain and physical mobility. As a trend, QoL in CVI stage IIIa (healed leg ulcer) corresponded to stage II, whereas stage IIIb and mixed ulcer showed similar results. In most areas, female patients were more affected by QoL reductions. Neither age differences nor other sociodemographic parameters accounted for the stage differences of CVI. The general emotional status did not differ from normal population. Conclusions: QoL in patients with CVI can be severely impaired. The degree of impairment can at least partially be predicted by the stage of the disease. Reduction of QoL may have negative social as well as economic effects. The data suggest that psychosocial problems, including the question of QoL, should be considered in the treatment of CVI.

Psychosomatic Aspects of Chronic Wounds

“…QoL was significantly improved in patients with healed leg ulcers. Contrary to Lindholm, there was not a higher proportion of men but of women being markedly affected by QoL reductions [Zschocke et al, 2002]. Basically, these data are also confirmed by Price [1996] and Smith et al [2000] who used variants of the SF-36 Health Survey in order to assess the QoL.…”

“…The ulcers were major factors reducing the work capacity of many patients. Augustin et al also noted corresponding limitations in a German-speaking population both with a disease-specific [Augustin et al, 1997;Zschocke et al, 2002] and a generic QoL questionnaire [Augustin et al, 1999a]. QoL was significantly improved in patients with healed leg ulcers.…”

Assessment of quality of life in Mexican patients suffering from chronic venous disorder – impact of oral Ruscus aculeatus-hesperidin–methyl-chalcone–ascorbic acid treatment – ‘QUALITY Study’

“…17,25,26 This combined approach is considered to be the most complete approach for evaluation of the management of patients with CVD. 27 In conclusion, the present study confirmed that R. aculeatus, combined with HMC and AA, is effective in reducing the symptoms and physical signs of CVD.…”

Quality of life assessment and use of patient-reported outcomes in practice

“…In many cases, Though not as severe as leg ulceration, chronic venous disease can also be of high patient burden. Previous studies suggest that the degree of impairment in HRQoL correlates with the stage of CVI (20). Accordingly, early detection and treatment of venous complaints is of great importance for preserving quality of life and functional capability.…”