Assessment of quality of life of patients with severe ischemia as a result of infrainguinal arterial occlusive disease

Abstract

The purpose of this cohort study was to assess the quality of life of patients with severe ischemia as a result of infrainguinal arterial occlusive disease. Spitzer's QL-INDEX was selected to measure quality of life at baseline and at 3, 6, and 12 months. On the basis of initial treatment, 61 patients were grouped as follows: IC (conservative, n = 31), IR (arterial reconstruction, n = 14), and IA (major amputation, n = 16). After 12 months of follow-up, 48 patients were similarly regrouped according to ultimate treatment as follows: UC (n = 19), UR (n = 9), and UA (n = 20). At 12 months the mean score was significantly higher than the baseline in IC (6.43 vs 3.84, p less than 0.0001) as well as IR (5.64 vs 3.57, p less than 0.01), but not in IA (4.43 vs 3.62). The QL-INDEX mean score was lower in UA than in UC (4.15 vs 6.58, p less than 0.01) or UR (4.15 vs 7.11, p less than 0.0001). The correlation between QL-INDEX and an arbitrary scale was also high (r = 0.726, p less than 0.001). In conclusion, quality of life of patients with limb ischemia can be confidently assessed, improves during the first year of follow-up if major amputation is avoided, and improves and is sustained by a functioning graft.

Effect of fibroblast growth factor NV1FGF on amputation and death: a randomised placebo-controlled trial of gene therapy in critical limb ischaemia

“…Although outcome is poorly documented, studies have supported the contention that prognosis is poor. [3][4][5][6] For example, 46% of patients unsuitable for revascularisation will have major amputation within 12 months, 3 with the substantial morbidity that this procedure entails. 2 years after a belowknee amputation, no more than 40% of the amputees will have reached full mobility, 15% will have had contralateral amputation and 15% an above-knee amputation, and 30% will have died.…”

“…2 years after a belowknee amputation, no more than 40% of the amputees will have reached full mobility, 15% will have had contralateral amputation and 15% an above-knee amputation, and 30% will have died. 4 Results from studies 5,6 have shown that the quality of life of a patient with critical limb disease equates to cancer patients with terminal disease.…”

Stem cell therapy for critical limb ischaemia — a review

“…As many as 10-40% of the patient population undergoes an amputation sometime during the course of the illness and the one year mortality has been estimated to be as high as 45% in these patients [5]. The quality of life in these patients have been described to be similar to those of terminal cancer patients [6]. Diabetes, if present makes a bleak situation even worse.…”

Plasmid-based gene therapy of diabetes mellitus

“…76 The quality of life during this period is limited. 77 Despite advances in revascularization techniques, limb salvage and relief of pain cannot be achieved…”