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Functional outcomes in limb salvage vascular surgery
M M Duggan1, J Woodson, T E Scott
1Department of Surgery, Boston University School of Medicine, Massachusetts 02118.
American Journal of Surgery
|August 1, 1994
Summary
Limb salvage surgery for critical limb ischemia in older adults has a high technical success rate but poor functional outcomes. Better definition of functional goals is needed to improve patient quality of life.
Area of Science:
- Vascular Surgery
- Geriatric Medicine
- Health Outcomes Research
Background:
- Healthcare crisis necessitates focus on defining successful medical treatment outcomes.
- Surgical literature often lacks assessment of functional outcomes alongside technical success.
Purpose of the Study:
- To evaluate the functional outcomes of limb salvage surgery in elderly patients with limb-threatening ischemia.
- To assess the impact of surgery on patient quality of life using a standardized health survey.
Main Methods:
- Prospective evaluation of 38 patients aged 65+ undergoing limb salvage surgery.
- Utilized the RAND-36-Item Health Survey 1.0 for functional health assessment over 3 years.
Main Results:
- Achieved an 80% limb salvage rate.
- Only 58% of patients survived 3 years; 25% survived with a functional limb capable of walking.
- RAND scores did not significantly differ between patients with amputated limbs and those with technically successful surgery.
Conclusions:
- Functional outcome goals require better definition for limb salvage vascular operations.
- Improved goal setting can enhance the quality of care for this patient population.
- Aligning functional outcomes with emerging health policy is crucial.