CARDIOVASCULAR JOURNAL OF AFRICA • Volume 25, No 3, May/June 2014
126
AFRICA
Buerger’s disease group, aorto-iliac involvement was present in
two (5.1%) patients, femoro-popliteal involvement was found in
10 (25.6%), and popliteo-crural involvement was present in 27
(69.2%) patients (
p
<
0.001).
According to chronic limb ischaemia criteria, Buerger’s
disease patients were found to be in an advanced stage at the
beginning of the study (Table 2). A total of 38.3% of patients
in the ASO group and 76.9% of those in the Buerger’s disease
group were in category 5 (
p
<
0.001).
The two groups were compared in terms of number of
operations performed at the time of hospital admission, and a
statistically significantly higher number of vascular operations
was observed in the ASO patients compared with the Buerger’s
disease patients. Peripheral vascular surgery was performed in a
total of 30 (63.8%) patients in the ASO group and nine (23.1%)
in the Buerger’s disease group (
p
<
0.001). When early vascular
complications related to vascular interventions were compared,
no significant differences were observed between the two groups
in terms of patency and thrombosis rates (data not presented).
The rate of minor and major amputations undertaken in the
contralateral leg was 4.2 and 4.2%, respectively in ASO patients.
The corresponding rates in Buerger’s disease patients were
20.5 and 10.3%, respectively. The rate of both minor and major
amputations in the contralateral leg was significantly higher in
Buerger’s disease patients (
p
=
0.027,
p
=
0.027, respectively).
The rate of minor amputations undertaken in the leg with a
lesion was 4.2% in ASO patients and 35.9% in Buerger’s disease
patients; this difference was statistically significant (
p
<
0.001).
The rate of amputation within one year of hospital admission
was found to be 23.4% in ASO patients and 48.7% in Buerger’s
disease patients (
p
<
0.05). There was no mortality in either
group during the one-year follow-up period.
Results of SF-36
The two groups were evaluated using the SF-36 score measuring
quality of life. A statistically significant difference was found
between the two groups in terms of pain at the time of hospital
admission and at six months post admission (
p
=
0.02,
p
=
0.001
respectively). Pain in Buerger’s disease patients was observed to
be more pronounced; however, this difference disappeared at 12
months (Table 3).
The SF-36 scores for patients with peripheral vascular disease
(irrespective of group) were compared according to category of
chronic limb ischaemia. The quality of life of patients whose
level of chronic limb ischaemia was category 5 and over at the
time of the first admission was worse in terms of pain, general
health, social function, emotional status and mental health than
that of patients with SF-36 scores less than category 5. These
parameters were found to be statistically significant (
p
=
0.02,
p
=
0.02,
p
=
0.02,
p
=
0.03,
p
=
0.04, respectively) (Table 4). The
difference in quality of life according to category of the SF-36
questionnaire disappeared at six and 12 months.
Using the SF-36, when ASO and Buerger’s disease patients
were divided into subgroups in terms of category of chronic
limb ischaemia, no significant difference was determined for
this parameter. However, when patients with advanced PAD in
category 5 and over were compared with patients with chronic
ischaemia of category 5 and over, there was no statistically
significant difference between these groups (data not presented).
Table 3. Evaluation of SF-36 between the groups
Quality-of-life
variables
First evaluation
6-month follow up
12-month follow up
Atherosclerosis
(
n
=
47)
Buerger’s
disease (
n
=
39)
p
-value
Atherosclerosis
(
n
=
33)
Buerger’s
disease (
n
=
33)
p
-value
Atherosclerosis
(
n
=
22)
Buerger’s
disease (
n
=
25)
p
-value
Physical function
27.3 ± 3.6
26.9 ± 4.2
0.94
53.4 ± 6.0
47.9 ± 5.5 0.50
67.9 ± 7.3
56.9 ± 6.2
0.26
Physical status
9.5 ± 3.9
3.8 ± 2.6
0.25
60.6 ± 8.3
44.2 ± 7.7 0.15
70.4 ± 9.6
50.5 ± 9.3
0.14
Social function
34.7 ± 3.7
26.4 ± 4.0
0.12
58.7 ± 5.2
47.7 ± 5.6 0.15
75.5 ± 7.5
70.7 ± 6.8
0.63
Body pain
30.1 ± 3.4
19.9 ± 2.7
0.02* 68.5 ± 5.0
41.3 ± 5.8 0.001* 78.6 ± 6.9
64.3 ± 8.1
0.19
Mental health
52.9 ± 3.6
50.6 ± 3.6
0.65
60.7 ± 4.2
54.2 ± 4.4 0.28
72.1 ± 3.7
65.2 ± 3.9
0.21
Emotional status
18.6 ± 4.9
11.9 ± 4.6
0.33
60.5 ± 7.9
49.3 ± 7.7 0.31
74.2 ± 9.2
56.1 ± 9.2
0.17
Vitality
36.0 ± 3.2
36.2 ± 3.3
0.97
52.6 ± 4.1
47.5 ± 4.2 0.39
62.7 ± 5.2
56.0 ± 4.0
0.31
General health
43.2 ± 2.5
37.4 ± 2.4
0.10
55.7 ± 3.2
49.3 ± 3.0 0.15
64.1 ± 4.7
62.1 ± 4.1
0.74
Values are median ± SE. p-values are between-group comparisons. *Statistically significant value.
Table 4. Evaluation of SF-36 according to category level for independent groups
Quality-of-life
variables
First evaluation
6-month follow up
12-month follow up
Category
≤
4
(
n
=
36)
Category
≥
5
(
n
=
50)
p-value
Category
≤
4
(
n
=
24)
Category
≥
5
(
n
=
43)
p-value
Category
≤
4
(
n
=
22)
Category
≥
5
(
n
=
25)
p-value
Physical function
28.3
±
4.0
26.3
±
3.7
0.71
58.7
±
6.8
46.1
±
4.9
0.61
63.7
±
8.6
61.1
±
5.7
0.81
Physical status
7.6
±
4.3
6.5
±
3.0
0.82
59.8
±
9.4
48.1
±
7.2
0.72
58.3
±
8.6
60.7
±
8.5
0.79
Pain
33.8
±
3.6
19.6
±
2.5
0.02* 63.9
±
6.3
49.7
±
5.4
0.55
73.0
±
7.7
69.7
±
7.4
0.78
General health
46.8
±
2.7
36.0
±
2.1
0.02* 57.0
±
3.5
49.9
±
2.8
0.81
63.0
±
5.1
63.0
±
3.9
0.92
Vitality
38.4
±
3.5
34.4
±
3.0
0.39
56.5
±
4.0
46.4
±
3.9
0.77
61.6
±
5.5
57.6
±
4.0
0.83
Social function
38.0
±
4.4
25.7
±
3.3
0.02* 62.8
±
5.9
47.7
±
4.9
0.54
73.1
±
8.3
72.8
±
6.4
0.81
Emotional status
24.3
±
6.3
9.3
±
3.5
0.03* 65.4
±
8.3
48.9
±
7.2
0.56
67.3
±
9.5
62.9
±
8.6
0.75
Mental health
58.0
±
3.9
47.5
±
3.3
0.04* 65.2
±
4.6
53.0
±
3.8
0.78
68.9
±
4.7
68.1
±
3.3
0.91
Values are median
±
SE.
p
-values are between-group comparisons. *Statistically significant value.
