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Age and Ageing 2004; 33: 236-241
Age and Ageing Vol. 33 No. 3 © British Geriatrics Society 2004; all rights reserved

Research Paper

Leg ulceration and perceived health: a population based case-control study

Andrew Jull1, Natalie Walker2, Maree Hackett1, Mark Jones1, Anthony Rodgers1, Nicholas Birchall3, Robyn Norton4 and Stephen MacMahon4

Clinical Trials Research Unit, University of Auckland
1 Private Bag 92019, Auckland
2 PO Box 2982 Christchurch Mail Centre, Christchurch, New Zealand
3 Auckland Dermatology, 17 Gilgit Road, Epsom, Auckland, New Zealand
4 Institute for International Health, PO Box 576, Newtown, Sydney, NSW 2042, Australia

Address correspondence to: A. Jull. Fax: (+64) 9 373 1710. Email: a.jull{at}ctru.auckland.ac.nz

Abstract

Objectives: to quantify the effect of leg ulceration on health-related quality of life and to estimate a health state value for leg ulceration.

Design: population based case-control study.

Setting: two New Zealand health districts (population 540,468 people).

Subjects: 241 people with a leg ulcer of any aetiology, and 224 controls randomly selected from the electoral roll using stratified sampling.

Main outcome measures: health-related quality of life as measured by the eight domains of the Short Form 36 question Health Survey, adjusted for age, sex and confounding co-morbidities; the physical component summary and mental component summary scores of the Short Form 36 question Health Survey standardised for age and sex; preference-based health state value derived from the Short Form 36 question Health Survey.

Results: completed Short Form 36 question Health Survey questionnaires were available for 230 cases (95%) and 218 controls (97%). Cases reported significantly lower mean scores than controls across all eight domains of the Short Form 36 question Health Survey (P < 0.0005). Mean domain scores for cases were also significantly lower than population norms. The mean physical component summary score for cases and controls was 45.2 versus 50.1 (P < 0.0001) and the mean mental component summary score was 48.1 for cases versus 51 for controls (P < 0.0001). The mean health state values (adjusted for age and sex) were 0.80 for cases and 0.89 for controls.

Conclusion: leg ulcers reduce quality of life to a similar extent as other common chronic conditions, such as arthritis and diabetes.

Keywords: leg ulcer, quality of life, health status, case-control studies, elderly

Received March 24, 2003; Revision received September 17, 2003. accepted in revised form September 17, 2003.


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