title: The quality of life in patients after peripheral bypass surgery deteriorates at long-term follow-up.
abstract: OBJECTIVE
  We aimed to study the long-term development of health-related quality of life (HR-QoL) in patients with peripheral arterial disease after they underwent peripheral bypass surgery and to evaluate the influence of adverse vascular events that occurred during follow-up.
  
  
  METHODS
  We compared current HR-QoL scores with previous measurements in patients who participated in the Dutch Bypass and Oral Anticoagulants or Aspirin (BOA) Study between 1995 and 1998 after they underwent infrainguinal bypass surgery. Patients from six centers that contributed most to the Dutch BOA Study (n = 482) were followed up retrospectively from 1995 up to 2009.
  
  
  RESULTS
  At a mean follow-up of 11 years since BOA randomization, 165 of the 482 patients were alive of whom 123 (75%) completed the EQ-5D and RAND-36 questionnaires. Fifty-three patients completed the questionnaires three times: at BOA entry, at BOA close-out, and at BOA long-term follow-up. In these patients the HR-QoL scores decreased over time, especially for the physical health dimension. In comparison with the general population, matched for age and gender, the HR-QoL scores at both BOA entry and long-term follow-up were substantially lower, even if the patient's graft was patent and no other vascular events had occurred. The occurrence of an adverse vascular event worsened the physical health state further.
  
  
  CONCLUSIONS
  The physical HR-QoL in patients with peripheral arterial disease (PAD) after peripheral bypass surgery was highly impaired, independent of graft patency, and deteriorated further over time. An adverse vascular event worsened the physical health state and underlined the importance of atherosclerotic risk management as well as stimulation of physical activity in patients with peripheral arterial disease to preserve HR-QoL.
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. evhattum@tsz.nl
authors.forename: Eline S
authors.initials: ES
authors.lastname: van Hattum
authors.forename: Marco J D
authors.initials: MJ
authors.lastname: Tangelder
authors.forename: James A
authors.initials: JA
authors.lastname: Lawson
authors.forename: Frans L
authors.initials: FL
authors.lastname: Moll
authors.forename: Ale
authors.initials: A
authors.lastname: Algra
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage; D001241:Aspirin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D058729:Peripheral Arterial Disease / Q000523:psychology / Q000601:surgery*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects / Q000523:psychology
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin