Kimpimäki Teija, Karhu Maria, Vaalasti Annikki, Karppinen Toni, Sintonen Harri, Huhtala Heini, Salmi Teea, Ahti Tiina
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Department of Dermatology, Tampere University Hospital, Tampere, Finland.
J Wound Care. 2025 May 2;34(5):350-358. doi: 10.12968/jowc.2022.0068.
The aim of the study was to investigate the health-related quality of life (HRQoL) of patients with hard-to-heal ulcers in a prospective study setting, and further to investigate the factors associated with HRQoL.
Patients with hard-to-heal ulcers referred to the Wound Centre of Tampere University Hospital, Finland, completed the 15D HRQoL questionnaire. The 15D scores were compared to an age- and sex-matched general population cohort and to patients with chronic pain and cancer. The baseline background and clinical data of patients with hard-to-heal ulcers were obtained from patient records and the Registry of Chronic Wounds at the Wound Centre, and follow-up information via questionnaires sent to the study participants six months after the first visit. Factors associated with baseline HRQoL and HRQoL changes during the follow-up were analysed.
A total of 142 patients with hard-to-heal ulcers were included in the study. The mean 15D score of the patients with hard- to-heal ulcers was lower than that of the general population cohort and patients with breast and prostate cancer, but higher than that of patients with chronic pain. Patients with an arterial or mixed ulcer had the lowest 15D scores, and negative correlations were detected between 15D scores and age, number of comorbidities and use of pain medication. During follow-up, the 15D score improved significantly in 43% of the patients, but ulcer healing was not associated with increasing 15D scores.
In this study, the HRQoL of patients with hard-to-heal ulcers was substantially impaired. In addition to ulcer aetiology, age and comorbidities were associated with HRQoL-highlighting the importance of multidisciplinary care-and this most likely explains the lack of correlation between ulcer healing and 15D score change during follow-up.
本研究旨在通过一项前瞻性研究，调查难愈合溃疡患者的健康相关生活质量（HRQoL），并进一步探究与HRQoL相关的因素。
转诊至芬兰坦佩雷大学医院伤口中心的难愈合溃疡患者完成了15D HRQoL问卷。将15D评分与年龄和性别匹配的普通人群队列以及慢性疼痛和癌症患者进行比较。难愈合溃疡患者的基线背景和临床数据来自患者记录以及伤口中心的慢性伤口登记处，并通过首次就诊六个月后发送给研究参与者的问卷获取随访信息。分析了与基线HRQoL以及随访期间HRQoL变化相关的因素。
本研究共纳入142例难愈合溃疡患者。难愈合溃疡患者的平均15D评分低于普通人群队列以及乳腺癌和前列腺癌患者，但高于慢性疼痛患者。动脉性或混合性溃疡患者的15D评分最低，且检测到15D评分与年龄、合并症数量和止痛药使用之间存在负相关。在随访期间，43%的患者15D评分显著改善，但溃疡愈合与15D评分增加无关。
在本研究中，难愈合溃疡患者的HRQoL受到严重损害。除溃疡病因外，年龄和合并症与HRQoL相关——这凸显了多学科护理的重要性——这很可能解释了随访期间溃疡愈合与15D评分变化之间缺乏相关性的原因。
