One-Year Prospective Health-Related Quality-Of-Life Outcomes in Patients Treated with Conservative Method, Endovascular Treatment or Open Surgery for Symptomatic Lower Limb Atherosclerotic Disease

• Published in: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology 2008-09, Vol.7 (3), p.247-256
• Main Authors: Koivunen, Kirsi, Lukkarinen, Hannele
• Format: Article
• Language: English
• Subjects: Aged; Atherectomy; Endarterectomy; Female; Health Behavior; Health Status; Humans; Intermittent Claudication - surgery; Intermittent Claudication - therapy; Male; Prospective Studies; Quality of Life; Treatment Outcome
• ISSN: 1474-5151; 1873-1953
• DOI: 10.1016/j.ejcnurse.2007.12.001

Background: There are no many reports on the long-term impacts of different treatments of lower limb atherosclerotic disease (LLAD) on patients' health behaviour, clinical outcome and health-related quality of life (HRQoL). Aims: The purpose of this study was to follow up the HRQoL of LLAD patients before and after the conservative, endovascular or surgical treatment. Methods: Patients who were treated conservatively (64 patients), scheduled for endovascular treatment (85 patients), or for elective surgery (31 patients) filled in the Nottingham Health Profile (NHP) questionnaire before treatment and 12 months after. The patients' background data were recorded, and their resting ankle-brachial pressure (ABI) was measured at baseline and 12 months later. Results: Smoking increased statistically significantly (p = 0.031) in the group of conservatively treated patients. The ABI and asymptomatic walking distance scores of the patients treated with endovascular (p = 0.000/p = 0.000) and surgical (p = 0.000/p = 0.000) procedures improved statistically significantly. Conservatively treated patients reported improvement of sleep (p = 0.047) and emotional reactions (p = 0.032). The patients with endovascular treatment reported improved emotional reactions (p = 0.016), energy (p = 0.027) and less social isolation (p = 0.050). The surgically treated patients reported improvement of pain (p = 0.001), mobility (p = 0.048), sleep (p = 0.030) and emotional reactions (p = 0.007). Conclusion: Deterioration of any clinical characteristics or HRQoL was not observed after any of the treatment modalities. Surgery gave LLAD patients a good clinical outcome and HRQoL for at least a year, whereas patients who were treated with endovascular and especially conservative treatment gained limited benefits.