The impact of walking impairment, cardiovascular risk factors, and comorbidity on quality of life in patients with intermittent claudication
The impact of walking impairment, cardiovascular risk factors, and comorbidity on quality of life in patients with intermittent claudication
复制标题
DOI：
10.1067/mva.2002.124369
复制
发表时间：
2002-07-01
影响因子：
4.3
通讯作者：
van Heck, GL
中科院分区：
文献类型：
--
作者：
Breek, JC;Hamming, JF;van Heck, GL
目的：本研究的目的是评估步行障碍、心血管危险因素和合并症对间歇性跛行（IC）患者生活质量（QOL）的影响。材料和方法：前瞻性观察研究在一所教学医院的血管门诊进行。使用世界卫生组织生活质量评估工具 100 的简化版对 200 名连续 IC 患者的生活质量进行了评估。简化后的工具评估生活质量的 5 个领域（身体和心理健康、独立水平、社会关系和环境）的 17 个方面。根据血管外科学会/国际心血管外科学会北美分会 (SVS/ISCVS) 的建议，年龄、性别、IC 程度、危险因素、合并症以及背部、髋部或膝盖症状的存在被分析为 QOL 的可能预测因素。以每个 QOL 方面和领域作为因变量进行多元回归分析。小于 0.05 的概率值被认为具有统计显着性。结果：发现男性是精力和疲劳以及睡眠和休息得分较高的预测因素。女性有更多的负面情绪。背部、臀部或膝盖症状的存在对于生活质量的许多方面都有重要的预测价值。随着伴随疾病的增多，患者在整体生活质量、一般健康以及精力和疲劳方面的得分较低，并且对药物和治疗表现出更多的依赖性。如 SVS/ISCVS 分类所示，IC 程度是 QOL 在独立水平及其方面的流动性、日常生活活动和工作能力以及疼痛和不适、性活动和交通方面的统计显着预测因子。高血压是 IC 患者 QOL 的第二个最重要的单一预测因素。结论：IC 患者的 QOL 仅部分取决于 SVS/ISCVS 分类中表达的步行限制的严重程度。在治疗政策中应认识到并考虑心血管危险因素和合并症以及背部、臀部或膝盖症状对生活质量的显着影响。
Objective: The objective of this study was to assess the impact of walking impairment, cardiovascular risk factors, and comorbidity on quality of life (QOL) in patients with intermittent claudication (IC).Material and methods: The prospective observational study was conducted in the setting of a vascular outpatient department of a teaching hospital. QOL was assessed in 200 consecutive patients with IC, with a reduced version of the World Health Organization Quality of Life Assessment Instrument-100. The reduced instrument assesses 17 facets of QOL within five domains (Physical and Psychological Health, Level of Independence, Social Relationships, and Environment). Age, gender, degree of IC, risk factors, comorbidity, as recommended by the Society for Vascular Surgery/North American Chapter of the International Society for Cardiovascular Surgery (SVS/ISCVS), and the presence of back, hip, or knee symptoms were analyzed as possible predictors of QOL. Multiple regression analyses were run with each of the QOL facets and domains as dependent variable. A probability value of less than .05 was considered to be statistically significant.Results: Male gender was found to be a predictor of better scores for Energy and Fatigue and for Sleep and Rest. Women had more Negative Feelings. The presence of back, hip, or knee symptoms was a significant predictive value for many aspects of QOL. With more concomitant diseases, patients had lower scores on the facets of Overall QOL and General Health and of Energy and Fatigue and showed more dependence on medication and treatments. The degree of IC, as expressed in the SVS/ISCVS classification, was a statistically significant predictor of QOL on the domain Level of Independence and its facets Mobility, Activities of Daily Living, and Working Capacity and the facets Pain and Discomfort, Sexual Activity, and Transport. Hypertension was the second most important single predictor of QOL in patients with IC.Conclusion: QOL in patients with IC is only partially determined by the severity of walking limitation as expressed in the SVS/ISCVS classification. The significant impact of cardiovascular risk factors and comorbidity and the presence of back, hip, or knee symptoms on QOL should be recognized and taken into account in the treatment policy.