Recovery Expectations and Quality of Life after Revascularization Treatments

Abstract

Aims: Despite the recognized effectiveness of revascularization treatments in patients with peripheral arterial disease (PAD), a significant number of patients continue to bear a compromised health related quality of life (HRQoL). The aim of this study was to investigate the role of patients’ recovery expectations in perceived health outcomes after lower-extremity revascularization. Study Design: Single-center prospective observational study, conducted in the Division of Vascular Surgery – S. Bortolo Hospital, Vicenza - between February 2011 and June 2012. Methodology: 60 consecutive patients, 26 with critical limb ischemia (CLI) and 34 with intermittent claudication (IC), undergoing open surgery (n = 38) or endovascular interventions (n= 22) were enrolled. Measurement of HRQoL (SF-36 and VascuQoL), mood states (HADS), pain (NRS) and functional status (Pain Disability Index, PDI)were administered before treatment (T1) and at 3-month follow-up (T2). Results: ANOVA showed a significant improvement (P < .001) from T1 to T2 in almost all the domains of VascuQoL and in ‘Bodily pain’ scale of SF-36. Positive changes in T2 were also identified in 11-point NRS pain intensity (P < .01) but not in mean scores of anxiety and depression. Recovery disappointment (negative differences between perceived and expected outcomes) in ‘Occupation’ and ‘Recreation’ scales of PDI were correlated (Pearson r coefficient) with lower improvement in HRQoL indices and higher scores of anxiety and depression. Conclusion: our findings evidence the role of expectations on perceived health outcomes after treatment in patients with PAD and underline the utility to help patients to develop realistic expectations.