Predictors of health after revascularization for extremity ischemia

Background. To assess the impact of surgical revascularization for lower ex tremity ischemia, we determined (with the use of the SF-36 health survey) t he functional health status of patients who underwent either inflow or outf low procedures. Methods. The SF-36 survey was given prospectively to 104 patients before op eration and at intervals ranging from 10 days to 1 year after operation fro m January 1998 to July 1999. To determine whether revascularization was ass ociated with improved patient health status, mean scores were compared befo re and after operation by univariate and multivariate analysis. To identify the factors that influenced patient health status, we performed multiple r egression analysis to test the hypothesis that outcome is affected by age, gender, time since procedure, diabetes, indication, and inflow versus outfl ow procedure. Results. There was a significant decrease in the general health score of pa tients before outflow bypass as compared with inflow procedure (45.3 +/- 5. 3 versus 32.1 +/- 3.3 [mean +/- SEM]; P < .05). After the procedure, only t hose patients who had undergone inflow procedures had improved outcome scor es. Diabetes, outflow procedures, limb salvage as indication, and time sinc e operation were determined by multiple regression affecting outcome scores to be significant factors. Conclusions. The SF-36 health survey demonstrated that diabetes, procedure type, indication, and time after procedure significantly affected the funct ional outcome for patients who were created surgically for lower extremity ischemia. Despite successful revascularization, significant deficits in fun ctional health remain in patients with lower extremity ischemia.