Functional outcomes in limb salvage vascular surgery.
BACKGROUND
The crisis in health care brings a new focus to defining successful outcomes of medical treatments. The surgical literature has been criticized for not assessing functional outcomes in addition to technical success.


METHODS
We evaluated the functional outcomes of limb salvage surgery over 3 years in 38 patients 65 years of age and older with limb-threatening ischemia. The RAND-36-Item Health Survey 1.0 was used as a health assessment tool.


RESULTS
In spite of an 80% limb salvage rate, only 58% of patients survived 3 years and only 25% survived with the index limb and were able to walk. The RAND scores of patients whose limbs were amputated did not significantly differ from those of patients whose surgery was successful.


CONCLUSIONS
Functional outcome goals need to be better defined for patients who need limb salvage vascular operations to enhance the quality of care given these patients and to be in concert with emerging health policy.
Duggan
M M
MM
Department of Surgery, Boston University School of Medicine, Massachusetts 02118.
Woodson
J
J
Scott
T E
TE
Ortega
A N
AN
Menzoian
J O
JO
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000674:Amputees; D001807:Blood Vessel Prosthesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D008297:Male; D010809:Physical Fitness; D011183:Postoperative Complications / Q000453:epidemiology; D011475:Prosthesis Failure; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome