Acute Limb Ischemia: Patient-reported Quality of Life and Ambulation Outcomes

Document Type

Conference Proceeding

Publication Date

6-1-2023

Publication Title

J Vasc Surg

Abstract

Objectives: There are few studies describing quality of life (QoL) and ambulation status after acute limb ischemia (ALI). We used a vascular disease-specific questionnaire (VascuQoL-6) and a generic quality of life assessment (European Quality of Life 5D-5L [EQ-5D]) to assess these outcomes.

Methods: Using a prospectively collected, single-institution ALI database, the EQ-5D and VascuQoL-6 surveys were administered. Patient demographics, medical history, inpatient variables, outcomes, and ambulatory functional status at last follow-up were collected. Univariate analyses were used to correlate the VascuQoL-6 composite score and the EQ-5D index score with the collected variables.

Results: Between May 2016 and February 2022, 234 patients were entered into the database; of these, 40 responded to our surveys (17%). Average age was 59 years, 55% were male, and 45% were Black. Rutherford class on presentation was 1 in 10 patients, 2a in 11 patients, 2b in 17 patients, and 3 in two patients. Three patients underwent medical management only, four patients had a primary amputation, 10 patients underwent endovascular revascularization, and 22 patients underwent an open revascularization. At 30 days, 93% of patients (37/40) had limb salvage; however, by 1 year, this decreased to 60% (22/37). Functional status at last follow-up (mean, 15-18 months) included 23 patients with normal ambulation, 10 patients with partially limited ambulation (neurological deficit or chronic pain), five ambulatory on prosthetics after amputation, and two non-ambulatory after amputation. Average VascuQoL-6 score was 16.8 (of a max of 24) for normal ambulation, 13.8 for partially limited ambulation, and 15.8 for prosthetic ambulation after amputation (P-value =.223). The VascuQoL-6 composite score was associated with age (inversely correlated; P <.001) and EQ-5D score (P <.001) only. The EQ-5D was also significant for age (inversely correlated; P =.032) and VascuQoL-6 composite score (P <.001), whereas ambulatory functional status approached significance (P =.079). Rutherford classification, etiology, type of revascularization, length of stay, limb salvage, and functional ambulatory status did not correlate with QoL outcomes on either assessment.

Conclusions: When comparing QoL after acute limb ischemia, younger patients had worse functional outcomes. There was no statistically significant difference in QoL for presenting Rutherford classification, limb salvage, type of revascularization, or functional ambulatory status.

Volume

77

Issue

6

First Page

e195

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