Quality of life, @entity323 , and activity level in a randomized trial of immediate repair versus surveillance of small XXXX .

@entity1 @entity323 @entity1028
OBJECTIVE: We compared long-term health-related quality-of-life outcome after randomization to immediate elective repair or imaging surveillance, and in relation to time of elective repair, in @entity1 with small asymptomatic @entity1028 ( @entity1028 ). METHODS: This randomized clinical trial was carried out in 16 Veterans Affairs medical centers. Study subjects were @entity1 at good surgical risk, aged 50 to 79 years, with AAAs 4.0 to 5.4 cm in diameter. Interventions included immediate open surgical @entity1028 repair or imaging surveillance every 6 months with repair reserved for AAAs that became symptomatic or enlarged to 5.5 cm. Main outcome measures considered were SF-36 health status questionnaire, prevalence of @entity323 , and maximum activity level, which were determined at randomization and at all follow-up visits. RESULTS: Eleven hundred thirty-six @entity1 were randomized and followed up for 3.5 to 8 years (mean, 4.9 years). The two randomized groups did not differ significantly for most SF-36 scales at most times, but the immediate repair group scored higher overall in general health (P <.0001), which was particularly evident in the first 2 years after randomization, and slightly lower in vitality (P <.05). The baseline value of one SF-36 scale, physical functioning, was an independent predictor of mortality. Overall, more @entity1 became @entity323 after randomization to immediate repair compared with surveillance (P <.03), but this difference did not become apparent until more than 1 year after randomization. Maximum activity level did not differ significantly between the two randomized groups, but decline over time was significantly greater in the immediate repair group (P <.02). CONCLUSIONS: For most quality-of-life measures and times there was no difference between randomized groups. Immediate repair resulted in a higher prevalence of @entity323 more than 1 year after randomization, but was also associated with improved perception of general health in the first 2 years.
