Survival and quality of life after arterial revascularization or major amputation for critical leg ischemia in Guadeloupe.
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.
Deneuville
Michel
M
Service de Chirurgie Vasculaire et Thoracique, CHU de Guadeloupe, Abymes, France. m.deneuville@chu-guadeloupe.fr
Perrouillet
Arnauld
A
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