Clinical and social consequences of XXXX .

@entity1 @entity39 @entity63 @entity1066 @entity613 @entity2119
PURPOSE: This study was undertaken to assess the clinical course of @entity2119 and to analyze the social problems that influence quality of life of affected @entity1 . @entity1 AND METHODS: One hundred ten @entity1 with @entity2119 (106 @entity1 , 4 @entity1 ; mean age, 40.0 years) for whom complete data since onset of disease were available were included in this retrospective study (mean follow-up, 10.6 years). Data were obtained by means of direct interview, written reports, or telephone. Data for deceased subjects were gathered from their families via written report or telephone. Graft patency was evaluated by means of ankle pressure measurement; and in all @entity1 with decreased ankle pressure arteriography was performed. RESULTS: Seven of 110 study @entity1 (6%) died during follow-up. Cumulative survival rate was 84% up to 25 years after the initial consultation. Results of bypass operations (n = 46) were not satisfactory. Primary graft patency was 41% at 1 year after operation, 32% at 5 years, and 30% at 10 years. Secondary graft patency was 54% at 1 year of follow-up, 47% at 5 years, and 39% at 10 years. However, major amputation was necessary in only 5 of 35 limbs (14%) with failed grafts. Forty-seven @entity1 (43%) underwent 108 amputation procedures, either major amputation (13 @entity1 ) or minor amputation (34 @entity1 ), of an upper or lower limb. No @entity63 @entity1066 occurred or recurred in @entity1 older than 60 years. Forty-one @entity1 who stopped smoking did not undergo major amputation. Furthermore, of 69 @entity1 who continued smoking, 13 @entity1 (19%) underwent major amputation. There was a correlation between incidence of continued smoking and limb amputation (P =.0070). In addition, 11 of 13 @entity1 who underwent major lower limb amputation (85%) lost their job, compared with 9 of 97 @entity1 without major amputation (9%). There was an association between limb amputation and job loss (P <.0001). All @entity1 who lost their jobs were engaged in manual labor. CONCLUSION: The natural course of life and limb is favorable in many @entity1 with @entity2119 . Occurrence or recurrence of @entity39 usually is arrested in @entity1 older than 60 years. To avoid factors that markedly influence quality of life, early treatment and strict instruction to prohibit smoking are mandatory. Arterial reconstruction shortens the healing process of @entity63 @entity1066 , despite poor long-term results. However, bypass surgery to treat @entity613 should be limited.
