Is amputation in the elderly patient with critical limb ischemia acceptable in the long term?

Chloé ML Peters,1 Jolanda de Vries,2,3 Eelco J Veen,1 Hans GW de Groot,1 Gwan H Ho,1 Paul Lodder,2,4 Stijn L Steunenberg,1 Lijckle van der Laan11Department of Surgery, Amphia Hospital, Breda, The Netherlands; 2Department of Medical and Clinical Psychology, Tilburg Univer...

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Autores principales:	Peters CML, de Vries J, Veen EJ, de Groot HGW, Ho GH, Lodder P, Steunenberg SL, van der Laan L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Amputation Critical Limb Ischemia Frail Elderly Health Status Quality of Life Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/f231eb52b4714e3092d3c439eaa4817e
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spelling	oai:doaj.org-article:f231eb52b4714e3092d3c439eaa4817e2021-12-02T04:53:02ZIs amputation in the elderly patient with critical limb ischemia acceptable in the long term?1178-1998https://doaj.org/article/f231eb52b4714e3092d3c439eaa4817e2019-07-01T00:00:00Zhttps://www.dovepress.com/is-amputation-in-the-elderly-patient-with-critical-limb-ischemia-accep-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Chloé ML Peters,1 Jolanda de Vries,2,3 Eelco J Veen,1 Hans GW de Groot,1 Gwan H Ho,1 Paul Lodder,2,4 Stijn L Steunenberg,1 Lijckle van der Laan11Department of Surgery, Amphia Hospital, Breda, The Netherlands; 2Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; 3Department of Medical Psychology, Elisabeth-Tweesteden Hospital (ETZ), Tilburg, The Netherlands; 4Department of Methodology and Statistics, Tilburg University, Tilburg, The NetherlandsPurpose: Despite high amputation rates, data on patient-reported outcomes is scarce in the elderly population with critical limb ischemia. The aim of this study was to provide mortality rates and long-term changes of the following patient-reported outcomes in elderly critical limb ischemia amputees: quality of life (QoL), health status (HS), and symptoms of depression.Patients and methods: In this prospective observational cohort study, amputated critical limb ischemia patients ≥70 years were included. The follow-up period was two years. Within the follow-up period patients completed the following questionnaires: the World Health Organization Quality Of Life -abbreviated version of the WHOQOL 100 (WHOQOL-BREF), the 12-Item Short Form Health Survey, and the Center for Epidemiological Studies Depression Scale.Results : A total of 49 elderly patients with critical limb ischemia had undergone major limb amputation within two years after inclusion. In these patients, the one-year mortality rate was 39% and the two-year mortality rate was 55%. The physical QoL was the only domain of the WHOQOL-BREF that improved significantly across time after amputation (p≤0.001). In the long-term, there was no difference in the ability to enjoy life (p=0.380) or the satisfaction in performing daily living activities (p=0.231) compared to the scores of the general elderly population. After amputation, the physical HS domain (p≤0.001) and the mental HS domain (p=0.002) improved. In the first year, amputees experienced less symptoms of depression (p=0.004).Conclusion: Elderly critical limb ischemia amputees are a fragile population with high mortality rates. Their QoL and HS increased after major limb amputation as compared to the baseline situation and they experienced less symptoms of depression. Moreover, our results show that, in the long-term, major limb amputation in the elderly patients with critical limb ischemia shows an acceptable QoL, which, in some aspects, is comparable to the QoL of their peers. These results can improve the shared-decision making process that does not delay the timing of major limb amputation.Keywords: amputation, critical limb ischemia, frail elderly, health status, quality of lifePeters CMLde Vries JVeen EJde Groot HGWHo GHLodder PSteunenberg SLvan der Laan LDove Medical PressarticleAmputationCritical Limb IschemiaFrail ElderlyHealth StatusQuality of LifeGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 14, Pp 1177-1185 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Amputation Critical Limb Ischemia Frail Elderly Health Status Quality of Life Geriatrics RC952-954.6
spellingShingle	Amputation Critical Limb Ischemia Frail Elderly Health Status Quality of Life Geriatrics RC952-954.6 Peters CML de Vries J Veen EJ de Groot HGW Ho GH Lodder P Steunenberg SL van der Laan L Is amputation in the elderly patient with critical limb ischemia acceptable in the long term?
description	Chloé ML Peters,1 Jolanda de Vries,2,3 Eelco J Veen,1 Hans GW de Groot,1 Gwan H Ho,1 Paul Lodder,2,4 Stijn L Steunenberg,1 Lijckle van der Laan11Department of Surgery, Amphia Hospital, Breda, The Netherlands; 2Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; 3Department of Medical Psychology, Elisabeth-Tweesteden Hospital (ETZ), Tilburg, The Netherlands; 4Department of Methodology and Statistics, Tilburg University, Tilburg, The NetherlandsPurpose: Despite high amputation rates, data on patient-reported outcomes is scarce in the elderly population with critical limb ischemia. The aim of this study was to provide mortality rates and long-term changes of the following patient-reported outcomes in elderly critical limb ischemia amputees: quality of life (QoL), health status (HS), and symptoms of depression.Patients and methods: In this prospective observational cohort study, amputated critical limb ischemia patients ≥70 years were included. The follow-up period was two years. Within the follow-up period patients completed the following questionnaires: the World Health Organization Quality Of Life -abbreviated version of the WHOQOL 100 (WHOQOL-BREF), the 12-Item Short Form Health Survey, and the Center for Epidemiological Studies Depression Scale.Results : A total of 49 elderly patients with critical limb ischemia had undergone major limb amputation within two years after inclusion. In these patients, the one-year mortality rate was 39% and the two-year mortality rate was 55%. The physical QoL was the only domain of the WHOQOL-BREF that improved significantly across time after amputation (p≤0.001). In the long-term, there was no difference in the ability to enjoy life (p=0.380) or the satisfaction in performing daily living activities (p=0.231) compared to the scores of the general elderly population. After amputation, the physical HS domain (p≤0.001) and the mental HS domain (p=0.002) improved. In the first year, amputees experienced less symptoms of depression (p=0.004).Conclusion: Elderly critical limb ischemia amputees are a fragile population with high mortality rates. Their QoL and HS increased after major limb amputation as compared to the baseline situation and they experienced less symptoms of depression. Moreover, our results show that, in the long-term, major limb amputation in the elderly patients with critical limb ischemia shows an acceptable QoL, which, in some aspects, is comparable to the QoL of their peers. These results can improve the shared-decision making process that does not delay the timing of major limb amputation.Keywords: amputation, critical limb ischemia, frail elderly, health status, quality of life
format	article
author	Peters CML de Vries J Veen EJ de Groot HGW Ho GH Lodder P Steunenberg SL van der Laan L
author_facet	Peters CML de Vries J Veen EJ de Groot HGW Ho GH Lodder P Steunenberg SL van der Laan L
author_sort	Peters CML
title	Is amputation in the elderly patient with critical limb ischemia acceptable in the long term?
title_short	Is amputation in the elderly patient with critical limb ischemia acceptable in the long term?
title_full	Is amputation in the elderly patient with critical limb ischemia acceptable in the long term?
title_fullStr	Is amputation in the elderly patient with critical limb ischemia acceptable in the long term?
title_full_unstemmed	Is amputation in the elderly patient with critical limb ischemia acceptable in the long term?
title_sort	is amputation in the elderly patient with critical limb ischemia acceptable in the long term?
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/f231eb52b4714e3092d3c439eaa4817e
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Is amputation in the elderly patient with critical limb ischemia acceptable in the long term?

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