Important differences between quality of life and health status in elderly patients suffering from critical limb ischemia

S L Steunenberg, J. de Vries, J.W. Raats, N. Verbogt, P. Lodder, G.J. van Eijck, E.J. Veen, H.G.W. de Groot, G.H. Ho, L. van der Laan

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Abstract

Introduction

Critical limb ischemia (CLI) patients are often of advanced age with reduced health status (HS) and quality of life (QoL) at baseline. Physical health is considered as the most affected domain due to reduced mobility and ischemic pain. QoL and HS are often used interchangeably in the current literature. HS refers to objectively perceived physical, psychological, and social functioning and in assessing QoL, change is measured subjectively and can only be determined by the individual since it concerns patients' evaluation of their functioning. It is important to distinguish between QoL and HS, especially in the concept of shared decision-making when the opinion of the patient is key. Goal of this study was to examine and compare QoL and HS in elderly CLI patients in relation to the used therapy, with a special interest in conservatively treated patients.

Methods

Patients suffering from CLI and ≥70 years old were included in a prospective study with a follow-up period of 1 year. Patients were divided into three groups; endovascular revascularization, surgical revascularization, and conservative therapy. The WHOQoL-Bref was used to determine QoL, and the 12-Item Short Form Health Survey was used to evaluate HS at baseline, 5-7 days, 6 weeks, 6 months, and 1 year.

Results

Physical QoL of endovascularly and surgically treated patients showed immediate significant improvement during follow-up in contrast to delayed increased physical HS at 6 weeks and 6 months (P<0.001). Conservatively treated patients showed significantly improved physical QoL at 6 and 12 months (P=0.02) in contrast to no significant improvement in physical HS.

Conclusion

This study demonstrates that QoL and HS are indeed not identical concepts and that differentiating between these two concepts could influence the choice of treatment in elderly CLI patients. Discriminating between QoL and HS is, therefore, of major importance for clinical practice, especially to achieve shared decision-making.

Original languageEnglish
Pages (from-to)1221-1226
JournalClinical Interventions in Aging
Volume14
DOIs
Publication statusPublished - 2019

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Health Surveys
Conservative Treatment

Keywords

  • Aged
  • Aged, 80 and over
  • Conservative Treatment/psychology
  • Female
  • Health Status
  • Humans
  • Ischemia/psychology
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life/psychology
  • Stress, Psychological/psychology
  • Treatment Outcome
  • Vascular Surgical Procedures/psychology

Cite this

Steunenberg, S L ; de Vries, J. ; Raats, J.W. ; Verbogt, N. ; Lodder, P. ; van Eijck, G.J. ; Veen, E.J. ; de Groot, H.G.W. ; Ho, G.H. ; van der Laan, L. / Important differences between quality of life and health status in elderly patients suffering from critical limb ischemia. In: Clinical Interventions in Aging. 2019 ; Vol. 14. pp. 1221-1226.
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title = "Important differences between quality of life and health status in elderly patients suffering from critical limb ischemia",
abstract = "IntroductionCritical limb ischemia (CLI) patients are often of advanced age with reduced health status (HS) and quality of life (QoL) at baseline. Physical health is considered as the most affected domain due to reduced mobility and ischemic pain. QoL and HS are often used interchangeably in the current literature. HS refers to objectively perceived physical, psychological, and social functioning and in assessing QoL, change is measured subjectively and can only be determined by the individual since it concerns patients' evaluation of their functioning. It is important to distinguish between QoL and HS, especially in the concept of shared decision-making when the opinion of the patient is key. Goal of this study was to examine and compare QoL and HS in elderly CLI patients in relation to the used therapy, with a special interest in conservatively treated patients.MethodsPatients suffering from CLI and ≥70 years old were included in a prospective study with a follow-up period of 1 year. Patients were divided into three groups; endovascular revascularization, surgical revascularization, and conservative therapy. The WHOQoL-Bref was used to determine QoL, and the 12-Item Short Form Health Survey was used to evaluate HS at baseline, 5-7 days, 6 weeks, 6 months, and 1 year.ResultsPhysical QoL of endovascularly and surgically treated patients showed immediate significant improvement during follow-up in contrast to delayed increased physical HS at 6 weeks and 6 months (P<0.001). Conservatively treated patients showed significantly improved physical QoL at 6 and 12 months (P=0.02) in contrast to no significant improvement in physical HS.ConclusionThis study demonstrates that QoL and HS are indeed not identical concepts and that differentiating between these two concepts could influence the choice of treatment in elderly CLI patients. Discriminating between QoL and HS is, therefore, of major importance for clinical practice, especially to achieve shared decision-making.",
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author = "Steunenberg, {S L} and {de Vries}, J. and J.W. Raats and N. Verbogt and P. Lodder and {van Eijck}, G.J. and E.J. Veen and {de Groot}, H.G.W. and G.H. Ho and {van der Laan}, L.",
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Steunenberg, SL, de Vries, J, Raats, JW, Verbogt, N, Lodder, P, van Eijck, GJ, Veen, EJ, de Groot, HGW, Ho, GH & van der Laan, L 2019, 'Important differences between quality of life and health status in elderly patients suffering from critical limb ischemia', Clinical Interventions in Aging, vol. 14, pp. 1221-1226. https://doi.org/10.2147/CIA.S202725

Important differences between quality of life and health status in elderly patients suffering from critical limb ischemia. / Steunenberg, S L; de Vries, J.; Raats, J.W.; Verbogt, N.; Lodder, P.; van Eijck, G.J.; Veen, E.J.; de Groot, H.G.W.; Ho, G.H.; van der Laan, L.

In: Clinical Interventions in Aging, Vol. 14, 2019, p. 1221-1226.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Important differences between quality of life and health status in elderly patients suffering from critical limb ischemia

AU - Steunenberg, S L

AU - de Vries, J.

AU - Raats, J.W.

AU - Verbogt, N.

AU - Lodder, P.

AU - van Eijck, G.J.

AU - Veen, E.J.

AU - de Groot, H.G.W.

AU - Ho, G.H.

AU - van der Laan, L.

PY - 2019

Y1 - 2019

N2 - IntroductionCritical limb ischemia (CLI) patients are often of advanced age with reduced health status (HS) and quality of life (QoL) at baseline. Physical health is considered as the most affected domain due to reduced mobility and ischemic pain. QoL and HS are often used interchangeably in the current literature. HS refers to objectively perceived physical, psychological, and social functioning and in assessing QoL, change is measured subjectively and can only be determined by the individual since it concerns patients' evaluation of their functioning. It is important to distinguish between QoL and HS, especially in the concept of shared decision-making when the opinion of the patient is key. Goal of this study was to examine and compare QoL and HS in elderly CLI patients in relation to the used therapy, with a special interest in conservatively treated patients.MethodsPatients suffering from CLI and ≥70 years old were included in a prospective study with a follow-up period of 1 year. Patients were divided into three groups; endovascular revascularization, surgical revascularization, and conservative therapy. The WHOQoL-Bref was used to determine QoL, and the 12-Item Short Form Health Survey was used to evaluate HS at baseline, 5-7 days, 6 weeks, 6 months, and 1 year.ResultsPhysical QoL of endovascularly and surgically treated patients showed immediate significant improvement during follow-up in contrast to delayed increased physical HS at 6 weeks and 6 months (P<0.001). Conservatively treated patients showed significantly improved physical QoL at 6 and 12 months (P=0.02) in contrast to no significant improvement in physical HS.ConclusionThis study demonstrates that QoL and HS are indeed not identical concepts and that differentiating between these two concepts could influence the choice of treatment in elderly CLI patients. Discriminating between QoL and HS is, therefore, of major importance for clinical practice, especially to achieve shared decision-making.

AB - IntroductionCritical limb ischemia (CLI) patients are often of advanced age with reduced health status (HS) and quality of life (QoL) at baseline. Physical health is considered as the most affected domain due to reduced mobility and ischemic pain. QoL and HS are often used interchangeably in the current literature. HS refers to objectively perceived physical, psychological, and social functioning and in assessing QoL, change is measured subjectively and can only be determined by the individual since it concerns patients' evaluation of their functioning. It is important to distinguish between QoL and HS, especially in the concept of shared decision-making when the opinion of the patient is key. Goal of this study was to examine and compare QoL and HS in elderly CLI patients in relation to the used therapy, with a special interest in conservatively treated patients.MethodsPatients suffering from CLI and ≥70 years old were included in a prospective study with a follow-up period of 1 year. Patients were divided into three groups; endovascular revascularization, surgical revascularization, and conservative therapy. The WHOQoL-Bref was used to determine QoL, and the 12-Item Short Form Health Survey was used to evaluate HS at baseline, 5-7 days, 6 weeks, 6 months, and 1 year.ResultsPhysical QoL of endovascularly and surgically treated patients showed immediate significant improvement during follow-up in contrast to delayed increased physical HS at 6 weeks and 6 months (P<0.001). Conservatively treated patients showed significantly improved physical QoL at 6 and 12 months (P=0.02) in contrast to no significant improvement in physical HS.ConclusionThis study demonstrates that QoL and HS are indeed not identical concepts and that differentiating between these two concepts could influence the choice of treatment in elderly CLI patients. Discriminating between QoL and HS is, therefore, of major importance for clinical practice, especially to achieve shared decision-making.

KW - Aged

KW - Aged, 80 and over

KW - Conservative Treatment/psychology

KW - Female

KW - Health Status

KW - Humans

KW - Ischemia/psychology

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Quality of Life/psychology

KW - Stress, Psychological/psychology

KW - Treatment Outcome

KW - Vascular Surgical Procedures/psychology

U2 - 10.2147/CIA.S202725

DO - 10.2147/CIA.S202725

M3 - Article

C2 - 31371929

VL - 14

SP - 1221

EP - 1226

JO - Clinical Interventions in Aging

JF - Clinical Interventions in Aging

SN - 1176-9092

ER -