Alabi Olamide, Roos Matthew, Landry Gregory, Moneta Gregory
Division of Vascular and Endovascular Surgery, Oregon Health & Science University, Portland, Ore.
Division of Vascular and Endovascular Surgery, Oregon Health & Science University, Portland, Ore.
J Vasc Surg. 2017 Feb;65(2):571-578. doi: 10.1016/j.jvs.2016.08.097. Epub 2016 Nov 19.
Critical limb ischemia (CLI) is a diagnosis plagued by significant comorbidity and high mortality rates. Overall survival remains poor in this population regardless of the procedure-related success as demonstrated by freedom from amputation, intervention, and patency. The literature has traditionally focused on physician-centered and lesion-centered outcomes with regards to limb salvage procedures, but there remains a relative paucity of studies of CLI patients describing patient-centered outcomes such as quality of life (QoL), independent living, and ambulation status. Review of the available literature indicates patients do not always experience significant gains in their QoL after limb salvage interventions, despite reasonable graft patency, amputation-free survival, and limb salvage rates. Further research is required using QoL tools in a measurable and clinically relevant fashion to guide optimal quality care that maximizes patient-centered outcomes.
严重肢体缺血(CLI)是一种受到显著合并症和高死亡率困扰的诊断。无论截肢、干预和通畅率所显示的与手术相关的成功率如何,该人群的总体生存率仍然很低。传统文献一直关注以医生为中心和以病变为中心的肢体挽救手术结果,但关于CLI患者的以患者为中心的结果,如生活质量(QoL)、独立生活和步行状态的研究相对较少。对现有文献的回顾表明,尽管移植血管通畅、无截肢生存率和肢体挽救率合理,但患者在肢体挽救干预后并不总是能在生活质量上获得显著改善。需要以可测量且与临床相关的方式使用生活质量工具进行进一步研究,以指导优化以患者为中心的结果的优质护理。