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

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.