Medical College of Wisconsin
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Health-related quality of life and functional outcome following arterial reconstruction for limb salvage. Cardiovasc Surg 1999 Apr;7(3):279-86

Date

07/01/1999

Pubmed ID

10386743

DOI

10.1016/s0967-2109(98)00142-2

Scopus ID

2-s2.0-0032919294   34 Citations

Abstract

Vascular surgery outcomes have traditionally been measured by limb salvage and graft patency. However, as health care resources are rationed, the patient's functional outcome and quality of life will require assessment. The in situ saphenous vein graft has proven successful in achieving long-term limb salvage for patients with critical ischemia, with the expectation of preserving a life-style and sense of well-being that would be lost with limb amputation. This study was conducted to measure functional capacity and quality of life in these patients. Seventy patients with successful in situ saphenous vein bypass grafts constructed for limb-threatening ischemia, followed for a mean of 45.6 months in a surveillance program with normal graft flow characteristics, were compared with a group of age and gender-matched controls with normal limb pressures and no history of vascular occlusive disease. A questionnaire was designed from standardized health status scales and administered to the two groups to assess symptoms, health perceptions, physical functioning and life quality. When comparing the groups of revascularized and control patients, symptoms and perceptions about their health were similar. However, the revascularized patients had significantly decreased functional capacity in their ability to walk various distances (P< or =0.005), perform household tasks (P< or =0.001) and bathe (P< or =0.001). The patient group with vascular grafts functioned as well as the controls only in activities of dressing and using the toilet. Indicators of life quality that rate independence and mobility, including the ability to procure groceries (P< or = 0.001), prepare meals (P< or =0.005) participate in social activities (P< or =0.001) and drive an automobile (P< or =0.01), were also significantly limited in the patients with successful vascular reconstructions. Although achieving long-term limb salvage and graft patency, the patients in this group of successful vascular reconstructions retain functional disabilities that require significant care. Despite these physical handicaps, these patients have a remarkably similar sense of well-being and lack of somatic complaints compared with the control group. This medical outcome study identifies the functional capacity and lifetime needs for vascular surgery patients that will provide useful data for those responsible for allocating health care resources.

Author List

Seabrook GR, Cambria RA, Freischlag JA, Towne JB

Author

Gary R. Seabrook MD Chief, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Activities of Daily Living
Aged
Aged, 80 and over
Arteries
Female
Follow-Up Studies
Health Care Rationing
Humans
Ischemia
Leg
Male
Middle Aged
Outcome Assessment (Health Care)
Patient Satisfaction
Postoperative Complications
Quality of Life
Salvage Therapy
Veins
jenkins-FCD Prod-398 336d56a365602aa89dcc112f077233607d6a5abc