Predictors of health after operation for aortoiliac occlusive and aneurysmal disease.
BACKGROUND
We assessed the impact of comorbid conditions and revascularization for aortoiliac occlusive and aneurysmal disease and determined the functional health status of patients with the Medical Outcomes Study SF36 Health Survey.


METHODS
One hundred twenty-five patients were surveyed prospectively, before operation, and at intervals ranging from 2 weeks to 2 years after operation. To identify the factors that influenced functional health, multiple regression analysis was performed to test the hypothesis that age, pulmonary disease, atherosclerotic heart disease, diabetes, aortoiliac occlusive disease (AOD) versus aneurysmal disease, and the preoperative physical summary score affected outcome.


RESULTS
Regression analysis identified that before operation, the physical summary score (PCS) was affected by pulmonary disease, atherosclerotic heart disease, and AOD, and patients with AOD had significantly worse PCS than patients with aneurysmal disease (43.2 +/- 12.6 vs 30.1 +/- 8.3, P <.05). This difference was also present after 3 to 12 months, and the preoperative PCS was the strongest predictor of the postoperative score. For patients followed up between 1 and 2 years, there was no significant difference among the groups, and atherosclerotic heart disease and pulmonary disease were identified to most affect the PCS.


CONCLUSIONS
Patients with AOD have significantly impaired physical function (as compared with patients with aneurysmal disease) that is successfully reversed with a surgical procedure. The functional health of patients after operation for aneurysmal disease returns to baseline after 3 and 12 months. Ultimately, cardiac and pulmonary comorbidities have a continued effect on the functional health of patients.
Nackman
G B
GB
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.
Banavage
A
A
Graham
A M
AM
D000203:Activities of Daily Living; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000523:psychology / Q000601:surgery; D006306:Health Surveys; D006801:Humans; D017543:Iliac Aneurysm / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D016014:Linear Models; D011237:Predictive Value of Tests; D011788:Quality of Life; D016019:Survival Analysis