The Effect of Selected Health, Demographic and Psychosocial Aspects on Quality of Life in Patients with Peripheral Arterial Occlusive Disease – a Prospective Analysis

Abstract

Background. Peripheral arterial occlusive disease (PAOD) is a prevalent atherosclerotic disorder characterized by exertional limb pain, loss of limb, and a high mortality rate. Because of its chronic nature, it often has a negative impact on a patient quality of life (QoL). Aims. To evaluate the effect of selected health, demographic and psychosocial aspects on QoL in respondents with PAOD. Patients and Methods. The study is a prospective and cross-sectional. It was carried out at the 2nd Department of Medicine of Charles University Hospital at the Faculty of Medicine in Hradec Králové, Czech Republic. Forty two respondents with PAOD (28 male, 14 female) were evaluated. All the respondents had involvement of femoral and popliteal arterial circulation. The number of all respondents in accordance with Fontaine classification was as follows: intermittent claudication: stage IIa – 4, stage IIb (<200 m) – 16, stage IIb (<50 m) – 9, chronic limb ischaemia: stage III – 6, stage IV – 7. The average age of all respondents was 65,4 years old (age range 45–79 years old). The study evaluates the effect of health aspects (stage of PAOD in accordance with Fontaine classification, diabetes mellitus, arterial hypertension, hyperlipidaemia, obesity, smoking), demographic (age, sex) and psychosocial aspects (level of education, marital status, religion) on QoL in respondents with PAOD. The Czech version of the International Generic European Quality of Life Questionnaire – EQ-5D was used. Results. The statistical evaluation presents statistically a significant dependence of QoL in respondents with PAOD on age (p < 0,01) and the stage of PAOD in accordance with the Fontaine classification (p < 0,01). The effect of other health, demographic and psychosocial aspects was statistically insignificant. Conclusion. The results had shown that with an increasing age and with a serious stage of PAOD in accordance with Fontaine classification, the QoL declines. The global QoL in respondents with PAOD is low.

Multicentre randomised controlled trial of the clinical and cost-effectiveness of a bypass-surgery-first versus a balloon-angioplasty-first revascularisation strategy for severe limb ischaemia due to infrainguinal disease. The Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial

“…72,73 However, as suggested above, HRQoL data do have limitations and have to be interpreted with caution in the context of an understanding of the clinical realities for this group of high-risk and highly morbid patients. [74][75][76][77] The response rates were low (equally so in both trial arms) beyond 12 months; this is disappointing but perhaps to be expected in this patient population. Responders were more likely to have their trial leg intact and, presumably therefore, to exhibit higher levels of generic, but especially disease-specific, HRQoL.…”

Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial: Health-related quality of life outcomes, resource utilization, and cost-effectiveness analysis

“…Beyond 12 months, response rates were equally low in both trial arms; this is disappointing but perhaps to be expected given the clinical realities for these high-risk patients with a range of comorbidities. [32][33][34] Responders were more likely to have an intact trial leg and, presumably therefore, to exhibit higher levels of generic but especially disease-specific HRQOL. [35][36][37][38][39][40][41] Like PREVENT III, nonresponse was associated with amputation, and this limited the information available to measure the effects of the alternative management strategies on HRQOL in this patient subgroup.…”

Quality of life and burden of disease in peripheral arterial disease: a study among Hungarian patients

“…A Medline adatbázisban ' peripheral arterial disease' AND 'EQ-5D' keresőszóval irodalomkeresést végeztünk. Összesen 23 találatunk volt, 20 találatot kizártunk betegpopulációs és mód-szertani eltérések miatt, három releváns vizsgálatot azonosítottunk [11,12,13].…”

“…Slovácek és mtsai [12] különböző egészségi állapotok, demográfi ai, pszichoszociális tényezők életminőségre gyakorolt hatását vizsgálták ballonos angioplasticán át-esett PAOD-betegek körében keresztmetszeti vizsgá-lattal. A kutatásba 42 cseh kórházi beteget vontak be.…”

“…Slovácek és mtsai [12] 42 fős (28 férfi , 14 nő), 65 éves átlagéletkorú kórházi beteg bevonásával készítették vizsgálatukat. Kutatásukban a PAOD-betegségre ható egyéb tényezők hatását kívánták felmérni, azonban a betegek életkorát kivéve a Fontaine-felosztás szerinti életminő-ség-eredmények nem mutattak szignifi káns összefüggést a vizsgált egészségi állapot jellemzőivel (cukorbetegség, magas vérnyomás, dohányzás), demográfi ai adatokkal (nem) és egyéb pszichoszociális tényezőkkel (iskolázott-ság, vallás, családi állapot).…”