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Published on: September 22, 2020
[The quality of life of patients with chronic lower limb ischemia]
Insights
Quality of life (QL) in chronic lower limb ischemia (CLLI) patients significantly improves post-vascular reconstruction. However, QL remains lower than the general population, especially with bypass thrombosis or limb amputation.
Area of Science:
- Vascular Surgery
- Patient Outcomes
- Quality of Life Research
Context:
- Chronic lower limb ischemia (CLLI) significantly impacts patient well-being.
- Vascular reconstruction is a common treatment for CLLI.
- Assessing quality of life (QL) is crucial for evaluating treatment efficacy.
Purpose:
- To evaluate the quality of life (QL) in patients with chronic lower limb ischemia (CLLI) before and after vascular reconstruction.
- To compare QL outcomes based on surgical success, bypass patency, and limb salvage.
Summary:
- Sixty-six CLLI patients (mean age 55.98, 96.9% male) were assessed using SF-36 and a CLLI-specific questionnaire.
- Post-vascular reconstruction, QL improved across all parameters compared to pre-operative levels, though it remained below the general population.
- QL was significantly better in patients with clinical improvement and patent bypasses, and worse in those with bypass thrombosis or limb amputation.
Impact:
- Vascular reconstruction offers significant QL improvements for CLLI patients.
- Long-term QL is positively associated with successful surgery and patent bypasses.
- Limb salvage and successful revascularization are critical for optimizing QL in CLLI patients.
Abstract:
Sixty-six patients with chronic lower limb ischemia (CLLI) were examined. The mean age of the patients constituted 55.98+/-7.7 (from 39 to 75 years). There were 64 (96.9%) men and 2 (3.1%) women. According to the runoff, the patients were distributed in the following way. Twenty-eight (41.8%) patients demonstrated good runoff, 23 (34.855) satisfactory, and 15 (23.2%) patients had poor runoff (according to the classification proposed by R.B.Rutherford). As dependent on the stage of ischemia the patients were divided into 2 groups. Twenty-eight (42.5%) patients presented with intermittent claudication (stage IIB) and 38 (57.5%) patients suffered from critical ischemia (st. III-IV). The quality of life (QL), was assessed using a SF-36 questionnaire and a questionnaire for patients with CLLI. After vascular reconstruction the QL of patients with infrainguinal artery lesion remained significantly low according to the majority of parameters as compared to the normal population. However, comparatively to the preoperative parameters, the QL after operation was significantly improved in all the indicators. The QL of patients with a clinical improvement after operation significantly differed from that in the patient group with a history of unsuccessful operation. In the long-term period, the QL of patients with bypass thrombosis was considerably worse in all the parameters than in patients with patent bypasses. As for the parameters of both questionnaires, the QL of patients with an amputated lower limb was appreciably worse than in patients with saved limbs.
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