Walking ability and quality of life as outcome measures in a comparison of arterial reconstruction and leg amputation for the treatment of vascular disease.

Abstract

To compare the walking ability and the quality of life of patients with severe limb ischaemia treated with an arterial reconstruction (AR) or a primary below-knee amputation (BKA). A cohort study of patients with the first episode of ischaemia. University tertiary referral centre. Thirty-eight (AR 22, BKA 16) patients were studied over a 12-month period with a complete follow-up. Walking ability was assessed with a subjective scale and quality of life was measured with the Spitzer QL-INDEX. The results were assessed for patients still alive (Step 1) as well as for all patients (Step 2). Walking ability was better in the AR group at 3 (OR = 10.37; CI 2.12; 50.74; p = 0.004), 6 (OR = 6.47; CI 1.83, 22.79; p = 0.004), and 12 (OR = 3.82; CI 1.20, 12.15; p = (0.03) months. Quality of life was significantly better for AR patients at 3 (OR = 4.32; CI 1.55, 12.02; p = 0.005) and 6 (OR = 4.40; CI 1.68, 11.53; p = (0.003) months, but not at 12 months (OR = 2.44; CI 0.95, 6.26; p = 0.06). the 12 month foot salvage rate was 68%. Walking ability and quality of life are better for AR patients than for BKA patients, even with a moderate food salvage rate.