Who suffers most from leg ulceration?

Abstract

This study examines health-related quality of life (HRQoL) in patients with leg ulceration and determines which patient groups are affected most by this condition. A cross-sectional study using the Nottingham Health Profile (NHP) and age/sex-matched normal scores in patients entering six clinical audit cycles was carried out. The 758 patients included in the study (mean age 74.6 years, 64% women) had been affected by leg ulceration for a median of 10.5 months (range 0.5 to 708). Patients produced significantly higher scores than age/sex-matched normal values for all domains of the NHP, indicating poorer HRQoL (all p < 0.001). Increasing age led to greater deficits in energy (p < 0.001) and mobility (p < 0.001) with greater social isolation (p = 0.044). Women experienced poorer energy, sleep patterns, mobility and emotional reactions (all p < 0.001), and increased physical pain and social isolation (p < 0.05) compared to men. However, higher scores may be expected for older women based on age/sex-matched normal values. After adjustment for age/sex-matched normal values, it was the younger patients who experienced a greater deficit in HRQoL over all domains of the NHP, with men scoring higher than women in the domains of bodily pain, sleep and social isolation (p < 0.001) and energy (p = 0.015). Leg ulceration has a major impact on patients' HRQoL as detected by the NHP. The excess in scores compared with age/sex-matched normal values indicate that it is younger male patients in whom ulceration makes a greater impact on HRQoL.