ABSTRACT
Measuring Health Related Quality of Life has become more and more important in evaluating patients with peripheral arterial disease. This prospective longitudinal survey aimed to investigate health related quality of life over time in patients with peripheral arterial disease (PAD) undergoing percutaneous transluminal angioplasty (PTA) between December 2005 and June 2008. Health Related Quality of life was assessed using the Claudication Scale (CLAU-S) and EQ5D and the Sense of Coherence Scale was used to estimate the patients' sense of coherence. The findings of this study shows that the total CLAU-S score was improved both at one-month follow-up (p < 0.0001) and one-year follow-up (p < 0.0001) compared to baseline. There were significant differences regarding all five dimensions: every day life, pain, social life, illness-specific fears and psychological wellbeing. The EQ5D computed by index improved significantly both at one-month follow-up (p = 0.0006) and one-year follow-up (p = 0.0019) compared to baseline. Differences were found between the groups with low and moderate sense of coherence (p = 0.0169) as well as between the groups with low and high sense of coherence (p = 0.0208) regarding health related quality of life (HRQoL). This study showed that PTA improves HRQoL among individuals suffering from PAD and that the effect is sustainable over time. For more accurate results, a disease-specific instrument should be used to evaluate HRQoL.
Subject(s)
Angioplasty , Peripheral Arterial Disease/psychology , Quality of Life , Adaptation, Psychological , Aged , Aged, 80 and over , Angioplasty/psychology , Female , Follow-Up Studies , Health Status Indicators , Humans , Male , Middle Aged , Pain Measurement , Peripheral Arterial Disease/therapy , Prognosis , Prospective Studies , Psychometrics , Statistics as Topic , Statistics, Nonparametric , Stress, Psychological , Surveys and Questionnaires , Time FactorsSubject(s)
Aspirin/administration & dosage , Platelet Aggregation Inhibitors/administration & dosage , Preoperative Care , Aspirin/adverse effects , Blood Loss, Surgical/prevention & control , Humans , Platelet Aggregation Inhibitors/adverse effects , Practice Patterns, Physicians' , Risk Factors , Time FactorsSubject(s)
Anaphylaxis/prevention & control , Dextrans/adverse effects , Dextrans/chemistry , Premedication/methods , Anaphylaxis/chemically induced , Anaphylaxis/immunology , Anaphylaxis/mortality , Antibody Formation/drug effects , Antibody Formation/immunology , Dextrans/administration & dosage , Dextrans/immunology , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Infusions, Intravenous , Male , Product Surveillance, Postmarketing , Risk Assessment , Structure-Activity Relationship , Survival AnalysisSubject(s)
Anaphylaxis/chemically induced , Dextrans/administration & dosage , Dextrans/adverse effects , Anaphylaxis/immunology , Anaphylaxis/prevention & control , Antibody Formation/drug effects , Antibody Formation/immunology , Dextrans/immunology , Humans , Premedication , Product Surveillance, Postmarketing , Risk FactorsABSTRACT
PURPOSE: In this prospective study we analyzed the immediate and midterm outcome in patients with abdominal aorta infection (mycotic aneurysm, prosthetic graft infection) managed by excision of the aneurysm or the infected vascular prosthesis and in situ replacement with a silver-coated polyester prosthesis. METHODS: From January 2000 to December 2001, 27 consecutive patients (25 men, 2 women; mean age, 69 years) with an abdominal aortic infection were entered in the study at seven participating centers. Infection was managed with either total (n = 18) or partial (n = 6) excision of the infected aorta and in situ reconstruction with an InterGard Silver (IGS) collagen and silver acetate-coated polyester graft. Assessment of outcome was based on survival, limb salvage, persistent or recurrent infection, and prosthetic graft patency. RESULTS: Twenty-four patients had prosthetic graft infections, graft-duodenal fistula in 12 and graft-colonic fistula in 1; and the remaining 3 patients had primary aortic infections. Most organisms cultured were of low virulence. The IGS prosthesis was placed emergently in 11 patients (41%). Mean follow-up was 16.5 months (range, 3-30 months). Perioperative mortality was 15%; all four patients who died had a prosthetic graft infection. Actuarial survival at 24 months was 85%. No major amputations were noted in this series. Recurrent infection developed in only one patient (3.7%). Postoperative antibiotic therapy did not exceed 3 months, except in one patient. No incidence of prosthetic graft thrombosis was noted during follow-up. CONCLUSION: Preliminary results in this small series demonstrate favorable outcome with IGS grafts used to treat infection in abdominal aortic grafts and aneurysms caused by organisms with low virulence. Larger series and longer follow-up will be required to compare the role of IGS grafts with other treatment options in infected fields.
