Predictors of Health-Related Quality of Life in Patients with Symptomatic Peripheral Arterial Disease

Abstract

PURPOSE: To identify predictors of baseline measures of health-related quality of life (HRQoL) in symptomatic patients with peripheral artery disease (PAD) from objective markers of severity of PAD, clinical and demographic characteristics, comorbid conditions, cardiovascular risk factors, objectively measured physical activity, and patient-based measures of physical function. METHODS: HRQoL measurements of 216 symptomatic men and women with PAD were assessed with the Medical Outcomes Study Short-Form 36 survey. Patients were further characterized on demographic variables, comorbid conditions, cardiovascular risk factors, ankle/brachial index, peak walking time (PWT) during a maximal treadmill test, 6-minute walk distance (6MWD), gait speed, ambulatory activity monitored during one week, activities of daily living (ADL), mini-mental state examination questionnaire, and walking impairment questionnaire (WIQ). RESULTS: For the physical function HRQoL subscale, the significant predictors included WIQ speed score (p < 0.001), a history of stumbling (p < 0.001), WIQ stair climbing score (p < 0.001), the ADL associated with bathing (p = 0.001), 6MWD (p = 0.004), and daily walking cadence (p = 0.043). For the role emotional function HRQoL subscale, the significant predictors included a history of stumbling (p < 0.001), the ADL associated with transferring from a bed to a chair (p < 0.001), and the WIQ distance score (p = 0.022). CONCLUSIONS: Physical and mental subscales of HRQoL in symptomatic patients with PAD are primarily predicted by patient-based physical function, rather than by more specific markers of PAD severity and comorbid conditions. The clinical significance is that interventions designed to improve HRQoL should focus on improving the quality of executing functional tasks such as walking more steadily without stumbling, completing ADL’s that are not specific to walking, such as bathing and transferring, and improving patient-based ability to walk various distances, speeds, and to climb stairs.