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Risk Factors Affecting Quality of Life in Chronic Limb Threatening Ischemia Patients
Rui Wu1, Yuan Yu1, Julong Guo1
1Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, People's Republic of China.
Insights
The Wound, Ischemia, and foot Infection (WIfI) classification significantly impacts the quality of life (QoL) for patients with chronic limb threatening ischemia (CLTI). Understanding WIfI stage is crucial for improving CLTI patient outcomes and QoL.
Area of Science:
- Vascular Surgery
- Patient Outcomes Research
- Quality of Life Studies
Background:
- Chronic limb threatening ischemia (CLTI) significantly impairs patients' quality of life (QoL).
- Identifying independent risk factors for QoL in CLTI is essential for targeted interventions.
- The Wound, Ischemia, and foot Infection (WIfI) classification is a key tool in assessing CLTI severity.
Purpose of the Study:
- To analyze independent risk factors influencing QoL in CLTI patients.
- To specifically evaluate the role of the WIfI classification in determining QoL outcomes.
- To provide insights for optimizing CLTI patient management and enhancing overall QoL.
Main Methods:
- A cohort of 309 hospitalized CLTI patients (Rutherford categories 4-6) was assessed.
- Quality of life was measured using the Vascular Quality of Life Questionnaire (VascuQoL).
- Linear regression models identified independent risk factors for overall VascuQoL scores and its dimensions, analyzing differences by WIfI stage.
Main Results:
- The WIfI classification was a significant independent predictor of overall VascuQoL scores and four QoL dimensions (activity, symptoms, emotional well-being, social interactions).
- Lower WIfI stages correlated with better QoL outcomes.
- Additional risk factors affecting QoL included female sex, smoking history, cerebral infarction history, and prior limb revascularization.
Conclusions:
- CLTI substantially diminishes patient QoL.
- The WIfI classification is a critical determinant of QoL in CLTI patients.
- WIfI staging provides valuable prognostic information for managing CLTI and improving patient well-being.
Purpose:
To analyze the independent risk factors affecting quality of life (QoL) in chronic limb threatening ischemia (CLTI) patients, with a particular focus on the role of the Wound, Ischemia, and foot Infection (WIfI) classification. Understanding these relationships could provide insights into optimizing patient management and improving their overall QoL.
Patients And Methods:
This study was conducted at our center from January 2021 to January 2024. Hospitalized patients diagnosed with CLTI (Rutherford categories 4-6) were enrolled for QoL assessment using the Vascular Quality of Life Questionnaire (VascuQoL). We analyzed the differences in the scores of vascuQoL and its five dimensions among patients grouped by different WIfI stages. A linear regression model was used to identify independent risk factors of overall VascuQoL scores and its different dimensions.
Results:
This study included 309 patients with an average age of 70.11 years; 30.1% were female. The mean baseline VascuQoL score was 2.02 ± 0.83. According to the WIfI classification, patients were distributed as follows: 15.53% stage 4, 39.16% stage 3, 27.83% stage 2, and 17.48% stage 1. WIfI classification emerged as a key independent predictor, significantly affecting overall VascuQoL scores (β=-0.15, 95% CI -0.24 to -0.06, P=0.002) and four out of five QoL dimensions (activity, symptoms, emotional well-being, and social interactions). Female sex, smoking history, cerebral infarction history, and previous limb revascularization also affect the quality of life from different dimensions or as a whole.
Conclusion:
CLTI markedly worsens patients' QoL, with WIfI stage playing a crucial role in determining outcomes.
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