title: Improvement of the quality of life concerning the health of patients with peripheral arterial disease (PAD) after successful bypass surgery.
abstract: BACKGROUND
  To test whether quality of life depends on the psyche of patients after successful bypass surgery for peripheral arterial disease (PAD).
  
  
  METHODS
  A total of 74 consecutive patients aged 36-69 years (57.7 +/- 8.8 years) with symptomatic PAD in the stages Fontaine IIb-IV were enrolled in a prospective study after successful bypass surgery. Because of bypass failure and one death during the study period, 11 of these patients were excluded from evaluation. Prior to surgery, Doppler sonography and digital subtraction angiography were carried out in all patients. Before and after revascularization, the ankle / brachial index (ABI) was determined in all study objects and the pain free walking distance (PFWD) in those with PAD stage Fontaine IIb. Health-related quality of life was measured by using the "Medical Outcomes Study Group Short Form 36" (SF-36), and personality was determined by employing the Psycho-Diagnostic-Test (PDT).
  
  
  RESULTS
  After surgery, there was an increase in ABI from 0.32 +/- 0.13 to 0.79 +/- 0.19 (p < .01), in PFWD from 42.6 m +/- 38.6 m to 419.7 m +/- 152.3 m (p < .01), and in the SF-36 scales "Physical functioning", "Bodily pain", "General health perceptions", and "Role-functioning physical" (p < .05). ABI correlated positively with "Bodily pain" (p < .01), "General health perceptions" (p < .01) and "Mental health" (p < .05). Among SF-36 and PDT-scales, "Role-functioning physical" correlated negatively with "Moodiness" / "Neuroticism" (p < .05), and "Social functioning" correlated positively with "General activity" (p < .01).
  
  
  CONCLUSIONS
  Whether objective clinical improvement increases quality of life mainly depends on the psyche of patients: A high level of general activity favors an improved quality of life and neurotic characteristics are more likely to be a hindrance.
authors.affiliation: Klinikum Augsburg, Klinik für Diagnostische Radiologie und Neuroradiologie, Augsburg, Germany.
authors.forename: W A
authors.initials: WA
authors.lastname: Wohlgemuth
authors.forename: O
authors.initials: O
authors.lastname: Safonova
authors.forename: M
authors.initials: M
authors.lastname: Engelhardt
authors.forename: M
authors.initials: M
authors.lastname: Freitag
authors.forename: K
authors.initials: K
authors.lastname: Wölfle
authors.forename: K
authors.initials: K
authors.lastname: Kirchhof
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D006801:Humans; D008875:Middle Aged; D009497:Neurotic Disorders / Q000523:psychology; D016491:Peripheral Vascular Diseases / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D010551:Personality; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D016138:Walking