Top

Gepubliceerd in:

09-02-2023

Health utility in community-dwelling adults with dysvascular lower limb loss

Auteurs: Sander L. Hitzig, Jorge Rios, Michael Devlin, Sara J. T. Guilcher, Crystal MacKay, Steven Dilkas, Michael W. Payne, Ricardo Viana, Ahmed Kayssi, Stephanie R. Cimino, Amanda L. Mayo

Gepubliceerd in: Quality of Life Research | Uitgave 7/2023

Abstract

Purpose

Adults with dysvascular lower extremity amputation (LEA) experience a large number of secondary health conditions yet there is a gap in the literature on health utility scores for this population. A health utility score relates to a person’s state of well-being, and is a single metric anchored at 0 (death) and 1 (perfect health). This study aimed to provide a descriptive account of health utility scores in community-dwelling adults with dysvascular LEA.

Methods

Participants were adults with dysvascular LEA who were 3 months post-amputation. Data collected included socio-demographic characteristics, the Special Interest Group in Amputee Medicine (SIGAM) grades, the dysvascular conditions scale (DCS), which is a scale developed for this study, and the Short Form-36 (SF-36). SF-6D health utility scores were derived from the SF-36 using a software algorithm. Participants were grouped into low-impact and high-impact groups based on self-reported severity of symptoms using the DCS. Health utility scores were compared between the low-impact and high-impact groups using independent t-tests.

Results

A total of 231 participants were enrolled in the study. The mean SF-6D health utility score was 0.689 (0.127). A significant association was found between health utility score and SIGAM grade (p < 0.001, η2 = .09). Health utility was positively associated with age (r = 0.137, p = 0.037) and months post-amputation (r = 0.141, p = 0.032), and negatively associated with DCS severity (r = -0.526, p < 0.001). Health utility scores were lower for participants in the DCS high-impact groups for conditions such as diabetes mellitus, phantom limb pain, musculoskeletal pain, back pain, psychological distress, depression, vision problems, and other pain.

Conclusion

Cost-utility analyses rely on health utility estimates and our findings provide data for future economic evaluations that may assist policy makers in evidence informed allocation of healthcare resources for this population.

vorige artikel Quality of life of patients and caregivers affected by bronchopulmonary dysplasia: a systematic review

volgende artikel Higher diet quality is associated with short and long-term benefits on SF-6D health state utilities: a 5-year cohort study in an international sample of people with multiple sclerosis

Hussain, M. A., Al-Omran, M., Salata, K., Sivaswamy, A., Forbes, T. L., Sattar, N., Aljabri, B., Kayssi, A., Verma, S., & de Mestral, C. (2019). Population-based secular trends in lower-extremity amputation for diabetes and peripheral artery disease. Canadian Medical Association Journal, 191(35), E955-e961. https://doi.org/10.1503/cmaj.190134CrossRefPubMedPubMedCentral

Imam, B., Miller, W. C., Finlayson, H. C., Eng, J. J., & Jarus, T. (2017). Incidence of lower limb amputation in Canada. Canadian Journal of Public Health, 108(4), e374–e380. https://doi.org/10.17269/cjph.108.6093CrossRefPubMed

Geiss, L. S., Li, Y., Hora, I., Albright, A., Rolka, D., & Gregg, E. W. (2019). Resurgence of diabetes-related nontraumatic lower-extremity amputation in the young and middle-aged adult U.S. population. Diabetes Care, 42(1), 50–54. https://doi.org/10.2337/dc18-1380CrossRefPubMed

Kayssi, A., de Mestral, C., Forbes, T. L., & Roche-Nagle, G. (2016). A Canadian population-based description of the indications for lower-extremity amputations and outcomes. Canadian Journal of Surgery, 59(2), 99–106. https://doi.org/10.1503/cjs.013115CrossRefPubMedCentral

Chen, L., Magliano, D. J., & Zimmet, P. Z. (2011). The worldwide epidemiology of type 2 diabetes mellitus–present and future perspectives. Nature Reviews. Endocrinology, 8(4), 228–236. https://doi.org/10.1038/nrendo.2011.183CrossRefPubMed

Vos, T., Allen, C., Arora, M., Barber, R. M., Bhutta, Z. A., Brown, A., Carter, A., Casey, D. C., Charlson, F. J., Chen, A. Z., Coggeshall, M., Cornaby, L., Dandona, L., Dicker, D. J., Dilegge, T., Erskine, H. E., Ferrari, A. J., Fitzmaurice, C., Fleming, T., & Murray, C. J. L. (2016). Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet, 388(10053), 1545–1602. https://doi.org/10.1016/s0140-6736(16)31678-6CrossRef

Fortington, L. V., Dijkstra, P. U., Bosmans, J. C., Post, W. J., & Geertzen, J. H. B. (2013). Change in health-related quality of life in the first 18 months after lower limb amputation: A prospective, longitudinal study. Journal of Rehabilitation Medicine, 45(6), 587–594. https://doi.org/10.2340/16501977-1146CrossRefPubMed

Essien, S. K., & Zucker-Levin, A. (2021). Factors associated with prolonged post-operative acute care length of stay in limb amputation patients in Saskatchewan. Canada. BMC Health Services Research, 21, 1128. https://doi.org/10.1186/s12913-021-07163-zCrossRefPubMed

Nadeau, K. J., Anderson, B. J., Berg, E. G., Chiang, J. L., Chou, H., Copeland, K. C., Hannon, T. S., Huang, T. T. K., Lynch, J. L., Powell, J., Sellers, E., Tamborlane, W. V., & Zeitler, P. (2016). Youth-onset type 2 diabetes consensus report: Current status, challenges, and priorities. Diabetes Care, 39(9), 1635. https://doi.org/10.2337/dc16-1066CrossRefPubMedPubMedCentral

10.

Hillier, T. A., & Pedula, K. L. (2003). Complications in young adults with early-onset type 2 diabetes. Diabetes Care, 26(11), 2999. https://doi.org/10.2337/diacare.26.11.2999CrossRefPubMed

11.

Liu, J.-J., Liu, S., Gurung, R. L., Ang, K., Tang, W. E., Sum, C. F., Tavintharan, S., & Lim, S. C. (2020). Risk of progressive chronic kidney disease in individuals with early-onset type 2 diabetes: A prospective cohort study. Nephrology, Dialysis, Transplantation, 35(1), 115–121. https://doi.org/10.1093/ndt/gfy211CrossRefPubMed

12.

Kaur, Y., Cimino, S. R., Albarico, M., Mayo, A. L., Guilcher, S. J. T., Robinson, L. R., Hanada, E., & Hitzig, S. L. (2021). Physical Function Outcomes in Patients with Lower-Limb Amputations Due to Trauma: A Systematic Review. Journal of Prosthetics and Orthotics, 33(2), 88–95. https://doi.org/10.1097/JPO.0000000000000313CrossRef

13.

Bhangu, S., Devlin, M., & Pauley, T. (2009). Outcomes of individuals with transfemoral and contralateral transtibial amputation due to dysvascular etiologies. Prosthetics and Orthotics International, 33(1), 33–40. https://doi.org/10.1080/03093640802492434CrossRefPubMed

14.

Mayo, A. L., Hitzig, S., & Cimino, S. (2019). A depiction of rehabilitation patients 65 years and younger with dysvascular lower extremity amputation. Canadian Prosthetics & Orthotics Journal. https://doi.org/10.33137/cpoj.v2i1.31950CrossRef

15.

Fajardo-Martos, I., Roda, O., Zambudio-Periago, R., Bueno-Cavanillas, A., Hita-Contreras, F., & Sánchez-Montesinos, I. (2018). Predicting successful prosthetic rehabilitation in major lower-limb amputation patients: A 15-year retrospective cohort study. Brazilian Journal of Physical Therapy, 22(3), 205–214. https://doi.org/10.1016/j.bjpt.2017.08.002CrossRefPubMed

16.

Marquez, M. G., Kowgier, M., & Journeay, W. S. (2020). Comorbidity and non-prosthetic inpatient rehabilitation outcomes after dysvascular lower extremity amputation. Canadian Prosthetics & Orthotics Journal. https://doi.org/10.33137/cpoj.v3i1.33916CrossRef

17.

Kristensen, M. T., Holm, G., Kirketerp-Møller, K., Krasheninnikoff, M., & Gebuhr, P. (2012). Very low survival rates after non-traumatic lower limb amputation in a consecutive series: What to do? Interactive Cardiovascular and Thoracic Surgery, 14(5), 543–547. https://doi.org/10.1093/icvts/ivr075CrossRefPubMedPubMedCentral

18.

Sinha, R., van den Heuvel, W. J. A., & Arokiasamy, P. (2011). Factors affecting quality of life in lower limb amputees. Prosthetics and Orthotics International, 35(1), 90–96. https://doi.org/10.1177/0309364610397087CrossRefPubMed

19.

Schoppen, T., Boonstra, A., Groothoff, J. W., De Vries, J., Göeken, L. N., & Eisma, W. H. (2002). Job satisfaction and health experience of people with a lower-limb amputation in comparison with healthy colleagues. American Journal of Physical Medicine & Rehabilitation, 83(5), 628–634. https://doi.org/10.1053/apmr.2002.32473CrossRef

20.

Sinha, R., & Van Den Heuvel, W. J. A. (2011). A systematic literature review of quality of life in lower limb amputees. Disability and Rehabilitation, 33(11), 883–899. https://doi.org/10.3109/09638288.2010.514646CrossRefPubMed

21.

Remes, L., Isoaho, R., Vahlberg, T., Hiekkanen, H., Korhonen, K., Viitanen, M., & Rautava, P. (2013). Major lower extremity amputation in elderly patients with peripheral arterial disease: Incidence and survival rates. Aging Clinical and Experimental Research, 20(5), 385–393. https://doi.org/10.1007/BF03325142CrossRef

22.

Mayfield, J. A., Reiber, G. E., Maynard, C., Czerniecki, J. M., Caps, M. T., & Sangeorzan, B. J. (2001). Survival following lower-limb amputation in a veteran population. Journal of Rehabilitation Research and Development, 38(3), 341–345.PubMed

23.

Aulivola, B., Hile, C. N., Hamdan, A. D., Sheahan, M. G., Veraldi, J. R., Skillman, J. J., Campbell, D. R., Scovell, S. D., LoGerfo, F. W., & Pomposelli, J. F. B. (2004). Major lower extremity amputation: Outcome of a modern series. Archives of Surgery, 139(4), 395–399. https://doi.org/10.1001/archsurg.139.4.395CrossRefPubMed

24.

Fortington, L. V., Geertzen, J. H. B., van Netten, J. J., Postema, K., Rommers, G. M., & Dijkstra, P. U. (2013). Short and long term mortality rates after a lower limb amputation. European Journal of Vascular and Endovascular Surgery, 46(1), 124–131. https://doi.org/10.1016/j.ejvs.2013.03.024CrossRefPubMed

25.

Vamos, E. P., Bottle, A., Majeed, A., & Millett, C. (2009). Trends in lower extremity amputations in people with and without diabetes in England, 1996–2005. Diabetes Research and Clinical Practice, 87(2), 275–282. https://doi.org/10.1016/j.diabres.2009.11.016CrossRef

26.

McWhinnie, D. L., Gordon, A. C., Collin, J., Gray, D. W. R., & Morrison, J. D. (1994). Rehabilitation outcome 5 years after 100 lower-limb amputations. The British Journal of Surgery, 81(11), 1596–1599. https://doi.org/10.1002/bjs.1800811110CrossRefPubMed

27.

Canadian Agency for Drugs and Technologies in Health (CADTH). Retrieved November 25, 2021, from https://www.cadth.ca/

28.

Drummond, M. F., O’Brien, B., Stoddart, G., & Torrance, G. W. (2005). Methods for the economic evaluation of health care programmes (3rd ed.). Oxford University Press.

29.

Gray, A. M., Clarke, P. M., Wolstenholme, J. L., & Wordsworth, S. (2010). Applied methods of cost-effectiveness analysis in healthcare. Oxford University Press.

30.

Whitehead, S. J., & Ali, S. (2010). Health outcomes in economic evaluation: The QALY and utilities. British Medical Bulletin, 96, 5–21. https://doi.org/10.1093/bmb/ldq033CrossRefPubMed

31.

Brazier, J., Roberts, J., & Deverill, M. (2002). The estimation of a preference-based measure of health from the SF-36. Journal of Health Economics, 21(2), 271–292. https://doi.org/10.1016/S0167-6296(01)00130-8CrossRefPubMed

32.

Ware, J. E., Kosinski, M., Dewey, J. E., & Gandek, B. (2000). SF-36 health survey: Manual and interpretation guide. Lincoln.

33.

Kopec, J. A., & Willison, K. D. (2003). A comparative review of four preference-weighted measures of health-related quality of life. Journal of Clinical Epidemiology, 56(4), 317–325. https://doi.org/10.1016/S0895-4356(02)00609-1CrossRefPubMed

34.

Gundle, K. R., Cizik, A. M., Punt, S. E. W., Conrad, E. U., 3rd., & Davidson, D. J. (2014). Validation of the SF-6D health state utilities measure in lower extremity sarcoma. Sarcoma. https://doi.org/10.1155/2014/450902CrossRefPubMedPubMedCentral

35.

Whitehurst, D. G. T., Bryan, S., & Lewis, M. (2011). Systematic review and empirical comparison of contemporaneous EQ-5D and SF-6D group mean scores. Medical Decision Making, 31(6), E34–E44. https://doi.org/10.1177/0272989X11421529CrossRefPubMed

36.

Hagberg, K., Hansson, E., & Brånemark, R. (2014). Outcome of percutaneous osseointegrated prostheses for patients with unilateral transfemoral amputation at two-year follow-up. American Journal of Physical Medicine & Rehabilitation, 95(11), 2120–2127. https://doi.org/10.1016/j.apmr.2014.07.009CrossRef

37.

Amtmann, D., Morgan, S. J., Kim, J., & Hafner, B. J. (2015). Health-related profiles of people with lower limb loss. American Journal of Physical Medicine & Rehabilitation, 96(8), 1474–1483. https://doi.org/10.1016/j.apmr.2015.03.024CrossRef

38.

Ryall, N. H., Eyres, S. B., Neumann, V. C., Bhakta, B. B., & Tennant, A. (2003). The SIGAM mobility grades: A new population-specific measure for lower limb amputees. Disability and Rehabilitation, 25(15), 833–844. https://doi.org/10.1080/0963828021000056460CrossRefPubMed

39.

O’Neill, B. F., & Evans, J. J. (2009). Memory and executive function predict mobility rehabilitation outcome after lower-limb amputation. Disability and Rehabilitation, 31(13), 1083–1091. https://doi.org/10.1080/09638280802509579CrossRefPubMed

40.

Kalpakjian, C. Z., Scelza, W. M., Forchheimer, M. B., & Toussaint, L. L. (2007). Preliminary reliability and validity of a spinal cord injury secondary conditions scale. The Journal of Spinal Cord Medicine, 30(2), 131–139. https://doi.org/10.1080/10790268.2007.11753924CrossRefPubMedPubMedCentral

41.

Mayo, A. L., Viana, R., Dilkas, S., Payne, M., Devlin, M., MacKay, C., Cimino, S. R., Guilcher, S. J. T., & Hitzig, S. L. (2022). Self-reported health condition severity and ambulation status postmajor dysvascular limb loss. Prosthetics and Orthotics International, 46(3), 239–245. https://doi.org/10.1097/PXR.0000000000000106CrossRefPubMed

42.

Hitzig, S. L., Dilkas, S., Payne, M. W., MacKay, C., Viana, R., Devlin, M., Cimino, S. R., Guilcher, S. J. T., & Mayo, A. L. (2022). Examination of social disconnectedness and perceived social isolation on health and life satisfaction in community-dwelling adults with dysvascular lower limb loss. Prosthetics and Orthotics International, 46(2), 155–163. https://doi.org/10.1097/PXR.0000000000000069CrossRefPubMed

43.

Engel, L., Bryan, S., Evers, S. M. A. A., Dirksen, C. D., Noonan, V. K., & Whitehurst, D. G. T. (2014). Exploring psychometric properties of the SF-6D, a preference-based health-related quality of life measure, in the context of spinal cord injury. Quality of Life Research, 23(8), 2383–2393. https://doi.org/10.1007/s11136-014-0677-9CrossRefPubMed

44.

Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.CrossRefPubMed

45.

Kharroubi, S. A., Brazier, J. E., Roberts, J., & O’Hagan, A. (2007). Modelling SF-6D health state preference data using a nonparametric bayesian method. Journal of Health Economics, 26(3), 597–612. https://doi.org/10.1016/j.jhealeco.2006.09.002CrossRefPubMed

46.

Brazier, J. E., & Roberts, J. (2004). The estimation of a preference-based measure of health from the SF-12. Medical Care, 42(9), 851–859. https://doi.org/10.1097/01.mlr.0000135827.18610.0dCrossRefPubMed

47.

Craven, C., Hitzig, S. L., & Mittmann, N. (2012). Impact of impairment and secondary health conditions on health preference among Canadians with chronic spinal cord injury. The Journal of Spinal Cord Medicine, 35(5), 361–370. https://doi.org/10.1179/2045772312y.0000000046CrossRefPubMedPubMedCentral

48.

Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behaviour Research and Therapy, 39(2), 175–191. https://doi.org/10.3758/bf03193146CrossRef

49.

Padovani, M. T., Martins, M. R., Venancio, A., & Forni, J. E. (2015). Anxiety, depression and quality of life in individuals with phantom limb pain. Acta Ortopédica Brasileira, 23(2), 107–110. https://doi.org/10.1590/1413-78522015230200990CrossRefPubMedPubMedCentral

50.

McDonald, S., Sharpe, L., & Blaszczynski, A. (2014). The psychosocial impact associated with diabetes-related amputation. Diabetic Medicine, 31(11), 1424–1430. https://doi.org/10.1111/dme.12474CrossRefPubMed

51.

Turner, A. P., Meites, T. M., Williams, R. M., Henderson, A. W., Norvell, D. C., Hakimi, K. N., & Czerniecki, J. M. (2015). Suicidal ideation among individuals with dysvascular lower extremity amputation. American Journal of Physical Medicine & Rehabilitation, 96(8), 1404–1410. https://doi.org/10.1016/j.apmr.2015.04.001CrossRef

52.

Fleury, A. M., Salih, S. A., & Peel, N. M. (2013). Rehabilitation of the older vascular amputee: A review of the literature. Geriatrics & Gerontology International, 13(2), 264–273. https://doi.org/10.1111/ggi.12016CrossRef

53.

Horgan, O., & MacLachlan, M. (2004). Psychosocial adjustment to lower-limb amputation: A review. Disability and Rehabilitation, 26(14–15), 837–850. https://doi.org/10.1080/09638280410001708869CrossRefPubMed

54.

Roepke, A. M., Williams, R. M., Turner, A. P., Henderson, A. W., Norvell, D. C., Henson, H., Hakimi, K. N., & Czerniecki, J. M. (2017). A longitudinal study of social participation after dysvascular lower extremity amputation. American Journal of Physical Medicine & Rehabilitation. https://doi.org/10.1097/PHM.0000000000000745CrossRef

55.

Czerniecki, J. M., Turner, A. P., Williams, R. M., Hakimi, K. N., & Norvell, D. C. (2012). Mobility changes in individuals with dysvascular amputation from the presurgical period to 12 months postamputation. American Journal of Physical Medicine & Rehabilitation, 93(10), 1766–1773. https://doi.org/10.1016/j.apmr.2012.04.011CrossRef

56.

Cutson, T. M., & Bongiorni, D. R. (1996). Rehabilitation of the older lower limb amputee: A brief review. Journal of the American Geriatrics Society, 44(11), 1388–1393.CrossRefPubMed

57.

Kurichi, J. E., Kwong, P. L., Reker, D. M., Bates, B. E., Marshall, C. R., & Stineman, M. G. (2007). Clinical factors associated with prescription of a prosthetic limb in elderly veterans. Journal of the American Geriatrics Society, 55(6), 900–906. https://doi.org/10.1111/j.1532-5415.2007.01187.xCrossRefPubMedPubMedCentral

58.

Davie-Smith, F., Coulter, E., Kennon, B., Wyke, S., & Paul, L. (2017). Factors influencing quality of life following lower limb amputation for peripheral arterial occlusive disease: A systematic review of the literature. Prosthetics and Orthotics International, 41(6), 537–547. https://doi.org/10.1177/0309364617690394CrossRefPubMed

59.

van den Berg, B. (2012). Sf-6d population norms. Health Economics, 21(12), 1508–1512. https://doi.org/10.1002/hec.1823CrossRefPubMed

60.

Whitehurst, D. G. T., Mittmann, N., Noonan, V. K., Dvorak, M. F., & Bryan, S. (2016). Health state descriptions, valuations and individuals’ capacity to walk: A comparative evaluation of preference-based instruments in the context of spinal cord injury. Quality of Life Research, 25(10), 2481–2496. https://doi.org/10.1007/s11136-016-1297-3CrossRefPubMed

61.

Du, X. D., Zhu, P., Li, M. E., Wang, J., Meng, H. D., & Zhu, C. R. (2018). Health utility of patients with stroke measured by EQ-5D and SF-6D. Journal of Sichuan University Medical Science Edition, 49(2), 252–257.PubMed

62.

Campbell, J. A., Jelinek, G. A., Weiland, T. J., Nag, N., Neate, S. L., Palmer, A. J., Mulhern, B., De Livera, A., & Simpson-Yap, S. (2020). SF-6D health state utilities for lifestyle, sociodemographic and clinical characteristics of a large international cohort of people with multiple sclerosis. Quality of Life Research, 29(9), 2509–2527. https://doi.org/10.1007/s11136-020-02505-6CrossRefPubMed

Titel: Health utility in community-dwelling adults with dysvascular lower limb loss
Auteurs: Sander L. Hitzig
Jorge Rios
Michael Devlin
Sara J. T. Guilcher
Crystal MacKay
Steven Dilkas
Michael W. Payne
Ricardo Viana
Ahmed Kayssi
Stephanie R. Cimino
Amanda L. Mayo
Publicatiedatum: 09-02-2023
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 7/2023
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-023-03357-6

Andere artikelen Uitgave 7/2023

Health-related quality of life and medication use among individuals with Angelman syndrome

Examining the psychometric properties of a split version of the EQ-5D-5L anxiety/depression dimension in patients with anxiety and/or depression

Open Access

Quality of life of patients and caregivers affected by bronchopulmonary dysplasia: a systematic review

Review

A systematic review of instruments measuring the quality of dying and death in Asian countries

Review

Reliability and validity of PRO-CTCAE® daily reporting with a 24-hour recall period

Open Access

Sexual quality of life in young gynaecological cancer survivors: a qualitative study

Open Access