One year health status benefits following treatment for new onset or exacerbation of peripheral arterial disease symptoms: The importance of patients' baseline health status

Moniek van Zitteren, Johan Denollet, J.M. Heyligers, J.W.M. Elshof, M.J. Nooren, D.H. Burger, W.M. de Fijter, P.W. Vriens, Kim Smolderen

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Abstract

Objective/Background
Limited information is available on expected health status gains following invasive treatment in peripheral arterial disease (PAD). One year health status outcomes following invasive treatment for PAD were compared, and whether pre-procedural health status was indicative of 1 year health status gains was evaluated.
Methods
Pre-procedural and 1 year health status (Short Form-12, Physical Component Score [PCS]) was prospectively assessed in a cohort of 474 patients, enrolled from 2 Dutch vascular clinics (March 2006–August 2011), with new or exacerbation of PAD symptoms. One year treatment strategy (invasive vs. non-invasive) and clinical information was abstracted. Quartiles of baseline health status scores and mean 1 year health status change scores were compared by invasive treatment for PAD. The numbers needed to treat (NNT) to obtain clinically relevant changes in 1 year health status were calculated. A propensity weight adjusted linear regression analysis was constructed to predict 1 year PCS scores.
Results
Invasive treatment was performed in 39% of patients. Patients with baseline health status scores in the lowest quartile undergoing invasive treatment had the greatest improvement (mean invasive 11.3 ± 10.3 vs. mean non-invasive 5.3 ± 8.5 [p = .001, NNT = 3]), whereas those in the highest quartile improved less (.8 ± 6.3 vs. –3.0 ± 8.2 [p = .025, NNT = 90]). Undergoing invasive treatment (p < .0001) and lower baseline health status scores (p < .0001) were independently associated with greater 1 year health status gains.
Conclusion
Substantial improvements were found in patients presenting with lower pre-procedural health status scores, whereas patients with higher starting health status levels had less to gain by an invasive strategy.Keywords: Atherosclerosis, Peripheral vascular disease, Revascularization
Original languageEnglish
Pages (from-to)213–222
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume50
Issue number2
DOIs
Publication statusPublished - 2015

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@article{221673382814438a90dc1aa3aaad631a,
title = "One year health status benefits following treatment for new onset or exacerbation of peripheral arterial disease symptoms: The importance of patients' baseline health status",
abstract = "Objective/BackgroundLimited information is available on expected health status gains following invasive treatment in peripheral arterial disease (PAD). One year health status outcomes following invasive treatment for PAD were compared, and whether pre-procedural health status was indicative of 1 year health status gains was evaluated.MethodsPre-procedural and 1 year health status (Short Form-12, Physical Component Score [PCS]) was prospectively assessed in a cohort of 474 patients, enrolled from 2 Dutch vascular clinics (March 2006–August 2011), with new or exacerbation of PAD symptoms. One year treatment strategy (invasive vs. non-invasive) and clinical information was abstracted. Quartiles of baseline health status scores and mean 1 year health status change scores were compared by invasive treatment for PAD. The numbers needed to treat (NNT) to obtain clinically relevant changes in 1 year health status were calculated. A propensity weight adjusted linear regression analysis was constructed to predict 1 year PCS scores.ResultsInvasive treatment was performed in 39{\%} of patients. Patients with baseline health status scores in the lowest quartile undergoing invasive treatment had the greatest improvement (mean invasive 11.3 ± 10.3 vs. mean non-invasive 5.3 ± 8.5 [p = .001, NNT = 3]), whereas those in the highest quartile improved less (.8 ± 6.3 vs. –3.0 ± 8.2 [p = .025, NNT = 90]). Undergoing invasive treatment (p < .0001) and lower baseline health status scores (p < .0001) were independently associated with greater 1 year health status gains.ConclusionSubstantial improvements were found in patients presenting with lower pre-procedural health status scores, whereas patients with higher starting health status levels had less to gain by an invasive strategy.Keywords: Atherosclerosis, Peripheral vascular disease, Revascularization",
author = "{van Zitteren}, Moniek and Johan Denollet and J.M. Heyligers and J.W.M. Elshof and M.J. Nooren and D.H. Burger and {de Fijter}, W.M. and P.W. Vriens and Kim Smolderen",
year = "2015",
doi = "10.1016/j.ejvs.2015.04.003",
language = "English",
volume = "50",
pages = "213–222",
journal = "European Journal of Vascular and Endovascular Surgery",
issn = "1078-5884",
publisher = "W.B. Saunders Ltd",
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One year health status benefits following treatment for new onset or exacerbation of peripheral arterial disease symptoms : The importance of patients' baseline health status. / van Zitteren, Moniek; Denollet, Johan; Heyligers, J.M.; Elshof, J.W.M.; Nooren, M.J.; Burger, D.H.; de Fijter, W.M.; Vriens, P.W.; Smolderen, Kim.

In: European Journal of Vascular and Endovascular Surgery, Vol. 50, No. 2, 2015, p. 213–222.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - One year health status benefits following treatment for new onset or exacerbation of peripheral arterial disease symptoms

T2 - The importance of patients' baseline health status

AU - van Zitteren, Moniek

AU - Denollet, Johan

AU - Heyligers, J.M.

AU - Elshof, J.W.M.

AU - Nooren, M.J.

AU - Burger, D.H.

AU - de Fijter, W.M.

AU - Vriens, P.W.

AU - Smolderen, Kim

PY - 2015

Y1 - 2015

N2 - Objective/BackgroundLimited information is available on expected health status gains following invasive treatment in peripheral arterial disease (PAD). One year health status outcomes following invasive treatment for PAD were compared, and whether pre-procedural health status was indicative of 1 year health status gains was evaluated.MethodsPre-procedural and 1 year health status (Short Form-12, Physical Component Score [PCS]) was prospectively assessed in a cohort of 474 patients, enrolled from 2 Dutch vascular clinics (March 2006–August 2011), with new or exacerbation of PAD symptoms. One year treatment strategy (invasive vs. non-invasive) and clinical information was abstracted. Quartiles of baseline health status scores and mean 1 year health status change scores were compared by invasive treatment for PAD. The numbers needed to treat (NNT) to obtain clinically relevant changes in 1 year health status were calculated. A propensity weight adjusted linear regression analysis was constructed to predict 1 year PCS scores.ResultsInvasive treatment was performed in 39% of patients. Patients with baseline health status scores in the lowest quartile undergoing invasive treatment had the greatest improvement (mean invasive 11.3 ± 10.3 vs. mean non-invasive 5.3 ± 8.5 [p = .001, NNT = 3]), whereas those in the highest quartile improved less (.8 ± 6.3 vs. –3.0 ± 8.2 [p = .025, NNT = 90]). Undergoing invasive treatment (p < .0001) and lower baseline health status scores (p < .0001) were independently associated with greater 1 year health status gains.ConclusionSubstantial improvements were found in patients presenting with lower pre-procedural health status scores, whereas patients with higher starting health status levels had less to gain by an invasive strategy.Keywords: Atherosclerosis, Peripheral vascular disease, Revascularization

AB - Objective/BackgroundLimited information is available on expected health status gains following invasive treatment in peripheral arterial disease (PAD). One year health status outcomes following invasive treatment for PAD were compared, and whether pre-procedural health status was indicative of 1 year health status gains was evaluated.MethodsPre-procedural and 1 year health status (Short Form-12, Physical Component Score [PCS]) was prospectively assessed in a cohort of 474 patients, enrolled from 2 Dutch vascular clinics (March 2006–August 2011), with new or exacerbation of PAD symptoms. One year treatment strategy (invasive vs. non-invasive) and clinical information was abstracted. Quartiles of baseline health status scores and mean 1 year health status change scores were compared by invasive treatment for PAD. The numbers needed to treat (NNT) to obtain clinically relevant changes in 1 year health status were calculated. A propensity weight adjusted linear regression analysis was constructed to predict 1 year PCS scores.ResultsInvasive treatment was performed in 39% of patients. Patients with baseline health status scores in the lowest quartile undergoing invasive treatment had the greatest improvement (mean invasive 11.3 ± 10.3 vs. mean non-invasive 5.3 ± 8.5 [p = .001, NNT = 3]), whereas those in the highest quartile improved less (.8 ± 6.3 vs. –3.0 ± 8.2 [p = .025, NNT = 90]). Undergoing invasive treatment (p < .0001) and lower baseline health status scores (p < .0001) were independently associated with greater 1 year health status gains.ConclusionSubstantial improvements were found in patients presenting with lower pre-procedural health status scores, whereas patients with higher starting health status levels had less to gain by an invasive strategy.Keywords: Atherosclerosis, Peripheral vascular disease, Revascularization

U2 - 10.1016/j.ejvs.2015.04.003

DO - 10.1016/j.ejvs.2015.04.003

M3 - Article

VL - 50

SP - 213

EP - 222

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

SN - 1078-5884

IS - 2

ER -