Health-related quality of life after revascularization for peripheral arterial occlusive disease: long-term follow-up.
OBJECTIVE
This paper reports a study to measure quality of life, before and after revascularization, in patients with intermittent claudication and critical limb ischaemia from a long-term perspective.


BACKGROUND
Patients with peripheral arterial occlusive disease have a number of problems which affect their quality of life and a successful revascularization results in immediate improvements in quality of life. However, knowledge of the durability of the improvements is sparse. Therefore, research on the outcomes of treatment and nursing care should investigate the long-term effects on quality of life and daily activities.


METHODS
A quasi-experimental longitudinal follow-up study was conducted with 80 patients with intermittent claudication and 62 with critical ischaemia. Assessment with the Nottingham Health Profile was made before revascularization and 6 months, 12 months and up to 4 years afterwards. The data were collected between 1995 and 2000.


RESULTS
Quality of life was improved 6 and 12 months after revascularization in patients with intermittent claudication in energy, pain, emotional reactions and physical mobility, while those with critical limb ischaemia also had improvements in pain and sleep. The improvement in pain was particularly evident for both groups and remained significantly improved up to 4 years after revascularization. Patients with critical limb ischaemia, however, deteriorated significantly with regard to physical mobility between 12 months and 4 years. Being a woman and belonging to the critical ischaemia group was significantly associated with high total Nottingham Health Profile score. Thus, patients with intermittent claudication had more durable benefits from revascularization than those with critical limb ischaemia. However, both groups had less pain than at baseline after 4 years.


CONCLUSIONS
The degree to which quality of life was durable over time seems to depend on the severity of the disease and gender. Patients with critical limb ischaemia were older, had more other diseases and a lower quality of life than patients with intermittent claudication, which confirmed that patients with critical limb ischaemia need more ongoing nursing support to maintain independence in daily life a long time after revascularization.
Wann-Hansson
Christine
C
Department of Nursing Science, Lund University, Lund, Sweden. christine.wann-hasson@med.lu.se
Hallberg
Ingalill Rahm
IR
Risberg
Bo
B
Lundell
Anders
A
Klevsgard
Rosemarie
R
D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000451:nursing / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000451:nursing / Q000628:therapy; D007511:Ischemia / Q000451:nursing / Q000628:therapy; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016491:Peripheral Vascular Diseases / Q000451:nursing / Q000628:therapy*; D011788:Quality of Life; D016896:Treatment Outcome