An analysis of relationship between quality of life indices and clinical improvement following intervention in patients with intermittent claudication due to femoropopliteal disease

Mazari, Fayyaz Ali Khan and Carradice, Daniel and Abdul Rahman, Mohd Norhisham Azmi and Khan, Junaid A. and Mockford, Katherine and Mehta, Tapan and McCollum, Peter T and Chetter, Ian C (2010) An analysis of relationship between quality of life indices and clinical improvement following intervention in patients with intermittent claudication due to femoropopliteal disease. Journal of Vascular Surgery, 52. pp. 77-84. ISSN 0741-5214

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Abstract

Objectives: To establish the relationship between quality of life (QOL) index scores and clinical indicators of lower limb ischemia. Methods: One hundred seventy-eight patients (108 men, median age 70 years) with femoropopliteal lesions suitable for angioplasty were recruited. Assessments were performed prior to and at 1, 3, 6, and 12 months following intervention (angioplasty and/or supervised exercise program). Clinical indicators of lower limb ischemia (treadmill walking distances, ankle pressures), generic (SF36, EuroQol), and disease-specific (Kings College VascuQol) quality of life questionnaires were analyzed. Correlation analysis was performed for index scores (SF-6D, EQ-5D, VascuQol) and individual domain scores using nonparametric tests. Results: All clinical indicators of lower limb ischemia and quality of life index scores showed a statistically significant improvement as result of intervention (Friedman test, P < .001). Both generic QOL index scores (SF-6D, EQ-5D) showed moderate but statistically significant correlation (Spearman’s rank correlation, P < .001) with treadmill walking distances (SF-6D r � 0.533, EQ-5D r�0.500) and weak but significant correlation to resting and postexercise ankle-brachial pressure index (SF-6D r�0.253, EuroQol r � 0.214). Disease-specific index scores (VascuQol) showed similar moderate correlation to treadmill walking distances (r � 0.584, P < .001) and weak but statistically significant correlation with resting and postexercise ABPI (r � 0.377, P < .001). All index scores showed strong and statistically significant (P<.001) correlation with patient-reported walking distance (SF-6D r� 0.604, EQ-5D r � 0.511, VascuQol r � 0.769). All domains of SF36 showed similar correlation with clinical indicators except general health. The strongest correlation was seen with treadmill walking distances in the domains of physical function (r�0.538) and bodily pain (r � 0.524). Conclusion: All generic and disease-specific QOL scores show statistically significant improvement with angioplasty and/or supervised exercise in patients with claudication due to femoropopliteal atherosclerosis. However, the degree of improvement seen in clinical indicators of lower limb ischemia is not reflected in these scores. These findings support the use of composite outcome measures with mandatory, independent assessment of QOL as an independent outcome measure in intervention studies in these patients.

Item Type:	Article (Journal)
Additional Information:	6953/58429
Uncontrolled Keywords:	Quality of life indices, clinical improvement, intermittent claudication
Subjects:	R Medicine > RD Surgery
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Surgery
Depositing User:	Dr M N A Abdul Rahman
Date Deposited:	25 Sep 2017 15:05
Last Modified:	25 Sep 2017 15:05
URI:	http://irep.iium.edu.my/id/eprint/58429

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