Predictors of health after revascularization for extremity ischemia.
BACKGROUND
To assess the impact of surgical revascularization for lower extremity ischemia, we determined (with the use of the SF-36 health survey) the functional health status of patients who underwent either inflow or outflow procedures.


METHODS
The SF-36 survey was given prospectively to 104 patients before operation and at intervals ranging from 10 days to 1 year after operation from January 1998 to July 1999. To determine whether revascularization was associated with improved patient health status, mean scores were compared before and after operation by univariate and multivariate analysis. To identify the factors that influenced patient health status, we performed multiple regression analysis to test the hypothesis that outcome is affected by age, gender, time since procedure, diabetes, indication, and inflow versus outflow procedure.


RESULTS
There was a significant decrease in the general health score of patients before outflow bypass as compared with inflow procedure (45.3 +/- 5.3 versus 32.1 +/- 3.3 [mean +/- SEM]; P <.05). After the procedure, only those patients who had undergone inflow procedures had improved outcome scores. Diabetes, outflow procedures, limb salvage as indication, and time since operation were determined by multiple regression affecting outcome scores to be significant factors.


CONCLUSIONS
The SF-36 health survey demonstrated that diabetes, procedure type, indication, and time after procedure significantly affected the functional outcome for patients who were treated surgically for lower extremity ischemia. Despite successful revascularization, significant deficits in functional health remain in patients with lower extremity ischemia.
Division of Vascular Surgery, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School and The Robert Wood Johnson University Hospital, New Brunswick, NJ 08903, USA.
G B
GB
Nackman
K
K
Horahan
A
A
Banavage
R G
RG
Ciocca
A M
AM
Graham
D000368:Aged; D015897:Comorbidity; D019992:Databases as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000401:mortality / Q000706:statistics & numerical data