AB1465-HPR Impact of ulcers in quality of life and foot function in systemic sclerosis patients
Authors: R Ghisleni, A. Janowska
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Systemic Sclerosis (SSc) is a progressive, highly disabling pathology associated with pain, functional limitation, loss of ability at work and high social costs. Recent studies have proved that quality of life is worst in SSc patients than in healthy people, however there is lack in literaly works investigating ulcers and lower limb complications. <h3>Objectives</h3> The aim of the present study is to investigate health-related quality of life and foot function in patients affected by SSc with or without ulcers. <h3>Methods</h3> 215 patients (mean age 48,6 years SD ±12,3) completed four questionnaires: Short-Form 36 (SF-36) and Health Assessement Questionnaire (HAQ) for quality of life, Foot Fuction Index (FFI) for foot fuction, Cardiff Wound Impact Scale (CWIS) for patients with ulcers only (88). Demographic data were also investigated such as sex, occupation and living place. In addition, further information about type of SSc, age at diagnosis of SSc, age at first Raynaud phenomenon, podiatric assessment and orthopaedic insoles or shoes wear was inquired. <h3>Results</h3> SF-36 scores were significantly lower in patients with ulcers than in patients without ulcers (p=0,001) as regards the physical component score (PCS). PCS was also positively correlated to its own sub-domain Physical Function (R=0,81), Role Physical (R=0,72) and Body Pain (R=0,71). SF-36 Mental component score (MCS) was positively correlated to its own sub-domain Mental Health (R=0,85) and Role Emotional (R=0,77). HAQ scores were significantly higher in patients with ulcers than in patients without ulcers (p&lt;0,001). PCS was negatively correlated to the HAQ (R=0,75). FFI scores were significantly higher in patients with ulcers than in patients without ulcers (p=0,001). CWIS scores were pretty high (50,6% SD ±26,6). Chi-square-test wasn't statistically significant (p=0.926): ulcers and age are not correlated. Only 17 patients out of 215 were used to wear orthopaedic footwear, 38 wore foot orthoses and 71 were informed about the figure of the podiatrist. <h3>Conclusions</h3> According to the literature,<sup>1–2</sup>patients with SSc show an impaired quality of life compared to healthy subjects. The majority of patients are unimployed or stay at home due to disability. Furthermore, in case of ulcers, the more pain grows, the more foot function is reduced as well as quality of life gets worse. Wounds could be considered as a biomarker of pathology progression; therefore, clinicians should pay more attention in prevention improving lower limb assessment and treatment. <h3>References</h3> [1] Rannou F, et al. Assessing disability and quality of life in systemic sclerosis: construct validities of the Cochin Hand Function Scale, Health Assessment Questionnaire (HAQ), Systemic Sclerosis HAQ, and Medical Outcomes Study 36-Item Short Form Health Survey. Arthritis Rheum. 2007Feb 15;57(1):94–102. [2] Hudson M, et al.; Canadian Scleroderma Research Group. Quality of life in patients with systemic sclerosis compared to the general population and patients with other chronic conditions. J Rheumatol. 2009Apr;36(4):768–72. <h3>Disclosure of Interest</h3> None declared