<p>Important differences between quality of life and health status in elderly patients suffering from critical limb ischemia</p>

Abstract

Introduction Critical limb ischemia (CLI) patients are often of advanced age with reduced health status (HS) and quality of life (QoL) at baseline. Physical health is considered as the most affected domain due to reduced mobility and ischemic pain. QoL and HS are often used interchangeably in the current literature. HS refers to objectively perceived physical, psychological, and social functioning and in assessing QoL, change is measured subjectively and can only be determined by the individual since it concerns patients’ evaluation of their functioning. It is important to distinguish between QoL and HS, especially in the concept of shared decision-making when the opinion of the patient is key. Goal of this study was to examine and compare QoL and HS in elderly CLI patients in relation to the used therapy, with a special interest in conservatively treated patients. Methods Patients suffering from CLI and ≥70 years old were included in a prospective study with a follow-up period of 1 year. Patients were divided into three groups; endovascular revascularization, surgical revascularization, and conservative therapy. The WHOQoL-Bref was used to determine QoL, and the 12-Item Short Form Health Survey was used to evaluate HS at baseline, 5–7 days, 6 weeks, 6 months, and 1 year. Results Physical QoL of endovascularly and surgically treated patients showed immediate significant improvement during follow-up in contrast to delayed increased physical HS at 6 weeks and 6 months ( P <0.001). Conservatively treated patients showed significantly improved physical QoL at 6 and 12 months ( P =0.02) in contrast to no significant improvement in physical HS. Conclusion This study demonstrates that QoL and HS are indeed not identical concepts and that differentiating between these two concepts could influence the choice of treatment in elderly CLI patients. Discriminating between QoL and HS is, therefore, of major importance for clinical practice, especially to achieve shared decision-making.

Quality of Life and Traditional Outcome Results at 1 Year in Elderly Patients Having Critical Limb Ischemia and the Role of Conservative Treatment

“…13 Current literature focuses on patient-related outcome measures for patients with CLI and considers health status without taking the subjective character of QoL into account. 14 Quality-of-life studies that compare the different treatment modalities are lacking in current literature, which hampers the ability to reflect upon the QoL results of this study. 5…”

Measuring Quality of Life in Chronic Limb-threatening Ischemia Patients and Informal Carers: A Scoping Review

“…Characteristics of each instrument are shown in Supplemental Table 3 (Table, Supplemental Digital Content 2, Supplemental Table 3, http://links.lww.com/SLA/D911). Sixteen of these instruments were used in 103 studies25–30,32–40,42–44,46–52,54–79,81,82,84–93,97–108,110–118,120–128,130–138,157 on QOL outcomes and CUA. These studies were conducted across 23 countries and published between 1992 and 2021.…”

“…There were 97 studies25–29,32,33,35–40,42–44,46–52,54–62,64–70,72–79,81,82,84–93,97–102,104–108,110–118,120–128,130–132,134–138,157 reporting QOL outcomes in CLTI patients (Table, Supplemental Digital Content 3, Supplemental Table 4, http://links.lww.com/SLA/D912). VascuQoL-25 was the most common disease-specific instrument used (n=17).…”

“…Of 6470 records identified in the primary database search, 114 studies25–138 were included. An additional 16 studies139–154 were included from the secondary database search and 16 studies155–170 from the reference list search.…”

“…An additional 16 studies139–154 were included from the secondary database search and 16 studies155–170 from the reference list search. In total, 146 studies25–170 were included for review (Fig. 1).…”