IMPACT OF INTERMITTENT CLAUDICATION ON QUALITY-OF-LIFE

Objectives: Surgical treatment of intermittent claudication is aimed p rimarily at improving quality of life, rather than survival. The aim o f this study was to examine the impact of claudication on quality of l ife and the ability of surgeons to judge this. Design and materials: 2 01 claudicants rated their quality of life and completed an SF36 healt h status questionnaire prior to their first consultation. Following th e consultation, the surgeons rated their perceptions of the patients' quality of life. Chief outcome measures: SF36 scores were compared wit h population norms. Multiple linear regression analysis determined the factors influencing quality of life. Agreement between surgeon and pa tient ratings of quality of life was expressed as a kappa coefficient. Main results: Compared to population norms, claudicants had significa ntly reduced quality of life in all respects. The severity of disease, as measured by stopping distance, was a significant predictor of gene ral health, pain, vitality and physical and social parameters. Mental and emotional wellbeing were also reduced, but were not related to dis ease severity. The agreement between patient and surgeon assessments o f quality of life was not high (k = 0.4). Patients had a higher percep tion of their quality of life than their surgeons. Conclusions: Interm ittent claudication impairs quality of life in all respects. The type of treatment offered to patients should reflect their quality of life at presentation, but subjective assessments by surgeons may not be suf ficiently accurate. Health status questionnaires have been used almost exclusively in research, but they may also be of use in clinical sett ings as an objective measure of quality of life.