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pubmed-article:10073763pubmed:abstractTextIntervention for vascular occlusive disease of the distal lower extremity in elderly patients will inevitably be scrutinized as medical resources decline. The authors applied surgical decision analysis to three treatment options: revascularization, amputation and expectant management. The appropriate outcome probabilities were derived from our experience with revascularization to the tibial and pedal vessels, and utility scores were obtained by formalized patient assessment. Revascularization was predicted to improve patient outcome by 1.10 quality-adjusted life-years compared with primary amputation and by 1.16 quality-adjusted life-years compared with expectant management. To gain one additional quality-adjusted life-years, revascularization would cost $5280 more than expectant management, but $33,900 less than primary amputation. Sensitivity analysis predicted revascularization to be the least costly treatment per quality-adjusted life-years as long as 1-month patency exceeds 11%. Revascularization for limb-threatening ischemia of the distal lower extremity is justified and can be performed at a reasonable cost.lld:pubmed
pubmed-article:10073763pubmed:languageenglld:pubmed
pubmed-article:10073763pubmed:journalhttp://linkedlifedata.com/r...lld:pubmed
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pubmed-article:10073763pubmed:authorpubmed-author:BrothersT ETElld:pubmed
pubmed-article:10073763pubmed:authorpubmed-author:RobisonJ GJGlld:pubmed
pubmed-article:10073763pubmed:authorpubmed-author:RiosG AGAlld:pubmed
pubmed-article:10073763pubmed:authorpubmed-author:ElliotB MBMlld:pubmed
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pubmed-article:10073763pubmed:volume7lld:pubmed
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pubmed-article:10073763pubmed:dateRevised2006-11-15lld:pubmed
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pubmed-article:10073763pubmed:year1999lld:pubmed
pubmed-article:10073763pubmed:articleTitleJustification of intervention for limb-threatening ischemia: a surgical decision analysis.lld:pubmed
pubmed-article:10073763pubmed:affiliationDepartment of Surgery, Medical University of South Carolina and Ralph Henry Johnson Department of Veterans Affairs Medical Center, Charleston 29425, USA. brothete@musc.edulld:pubmed
pubmed-article:10073763pubmed:publicationTypeJournal Articlelld:pubmed
pubmed-article:10073763pubmed:publicationTypeResearch Support, U.S. Gov't, Non-P.H.S.lld:pubmed