title: Survival and quality of life after arterial revascularization or major amputation for critical leg ischemia in Guadeloupe.
abstract: Functional outcome and survival in 253 patients treated for critical leg ischemia (CLI) in Guadeloupe (French West Indies) were analyzed. Analysis included calculation of quality-of-life score (QLS) from telephone survey data, with a median follow-up time of 42 months (range 12-109). A slight but significant benefit was observed in the 140 patients who underwent arterial reconstruction, with 76% autonomous ambulatory function, 51% independent residential status, and a QLS of 6.9 +/- 1.5 in comparison with the 113 patients who underwent amputation: 34%, 17%, and 5.1 +/- 2, respectively (p < 0.0001). Survival was comparable in the two groups. Inadequate medical follow-up that was either totally lacking or performed only in case of recurrent CLI as well as low rates of rehabilitation (50%) and prosthetic fitting (32%) in the amputation group highlight the existence of a double problem involving therapeutic compliance and vascular follow-up care/rehabilitation in Guadeloupe.
authors.affiliation: Service de Chirurgie Vasculaire et Thoracique, CHU de Guadeloupe, Abymes, France. m.deneuville@chu-guadeloupe.fr
authors.forename: Michel
authors.initials: M
authors.lastname: Deneuville
authors.forename: Arnauld
authors.initials: A
authors.lastname: Perrouillet
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000671:Amputation, Surgical / Q000401:mortality* / Q000706:statistics & numerical data; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D005500:Follow-Up Studies; D019430:Guadeloupe / Q000453:epidemiology; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007511:Ischemia / Q000401:mortality* / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D007866:Leg / Q000098:blood supply*; D023821:Limb Salvage / Q000401:mortality* / Q000706:statistics & numerical data; D008297:Male; D011788:Quality of Life; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000401:mortality* / Q000706:statistics & numerical data