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Jan Apelqvist

Physician

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Importance of factors determining the low health-related quality of life in people presenting with a diabetic foot ulcer: the Eurodialestudy

Author

  • V. Siersma
  • H. Thorsen
  • P. E. Holstein
  • M. Kars
  • Jan Apelqvist
  • E. B. Jude
  • A. Piaggesi
  • K. Bakker
  • M. Edmonds
  • A. Jirkovska
  • D. Mauricio
  • G. Ragnarson Tennvall
  • H. Reike
  • M. Spraul
  • L. Uccioli
  • V. Urbancic
  • K. van Acker
  • J. van Baal
  • N. C. Schaper

Summary, in English

AimTo identify the factors responsible for the low health-related quality of life associated with foot ulcers and the relative importance of these factors. MethodsA total of 1232 patients with a new foot ulcer, who presented at one of the 14 centres in 10 European countries participating in the Eurodiale study, were included in this cross-sectional study. Patient and ulcer characteristics were obtained as well as results from the Euro-Qol-5D questionnaire, a health-related quality of life instrument with five domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). To analyse the relative importance of comorbidities and ulcer- and patient-related factors for health-related quality of life, linear regression models were used to calculate the relative contributions of each factor to the fit (R-2) of the model. ResultsPatients reported poor overall health-related quality of life, with problems primarily in the mobility and pain/discomfort domains. Among the comorbidities, the inability to stand or walk without help was the most important determinant of decreased health-related quality of life in all five domains. Among ulcer-related factors, ulcer size, limb-threatening ischaemia and elevated C-reactive protein concentration also had high importance in all domains. The clinical diagnosis of infection, peripheral arterial disease and polyneuropathy were only important in the pain/discomfort domain. ConclusionsThe factors that determine health-related quality of life are diverse and to an extent not disease-specific. To improve health-related quality of life, treatment should not only be focused on ulcer healing but a multifactorial approach by a specialized multidisciplinary team is also important. What's new? The inability to stand or walk without help is the most important determinant of poor health-related quality of life. Other factors with high importance are ulcer size, elevated C-reactive protein concentration and limb-threatening ischaemia. To improve health-related quality of life, treatment should not only be focused on ulcer healing but a multifactorial approach by a specialized multidisciplinary team is also important.

Department/s

  • Genomics, Diabetes and Endocrinology

Publishing year

2013

Language

English

Pages

1382-1387

Publication/Series

Diabetic Medicine

Volume

30

Issue

11

Document type

Journal article

Publisher

Wiley-Blackwell

Topic

  • Endocrinology and Diabetes

Status

Published

Research group

  • Genomics, Diabetes and Endocrinology

ISBN/ISSN/Other

  • ISSN: 1464-5491