Truncal varicose vein diameter and patient-reported outcome measures

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Title: Truncal varicose vein diameter and patient-reported outcome measures
Authors: Lane, TRA
Varatharajan, L
Fiorentino, F
Shepherd, AC
Zimmo, L
Gohel, MS
Franklin, IJ
Davies, AH
Item Type: Journal Article
Abstract: Background Varicose veins and chronic venous disease are common, and some funding bodies ration treatment based on a minimum diameter of the incompetent truncal vein. This study assessed the effect of maximum vein diameter on clinical status and patient symptoms. Methods A prospective observational cohort study of patients presenting with symptomatic varicose veins to a tertiary referral public hospital vascular clinic between January 2011 and July 2012. Patients underwent standardized assessment with venous duplex ultrasonography, and completed questionnaires assessing quality of life (QoL) and symptoms (Aberdeen Varicose Vein Questionnaire, EuroQol Five Domain QoL assessment and EuroQol visual analogue scale). Clinical scores (Venous Clinical Severity Score (VCSS) and Clinical Etiologic Anatomic Pathophysiologic (CEAP) class) were also calculated. Regression analysis was used to investigate the relationship between QoL, symptoms and vein diameter. Results Some 330 patients were assessed before surgery. The median maximum vein diameter was 7·0 (i.q.r. 5·3–9·2) mm overall, 7·9 (6·0–9·8) mm for great saphenous vein and 6·0 (5·2–8·9) mm for small saphenous vein. In linear regression analysis, vein diameter was shown to have a significant association with VCSS (P = 0·041). For every 1-mm increase in vein diameter, there was a 2·75-fold increase in risk of being in CEAP class C4 compared with C2. No other QoL or symptom measures were related to vein diameter. Conclusion Incompetent truncal vein diameter was associated with increasing VCSS, but not a variety of other varicose vein disease-specific and generic patient-reported outcome measures.
Issue Date: 2-Aug-2017
Date of Acceptance: 14-Apr-2017
ISSN: 1365-2168
Publisher: Wiley
Start Page: 1648
End Page: 1655
Journal / Book Title: British Journal of Surgery
Volume: 104
Issue: 12
Copyright Statement: © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd. This is the accepted version of the following article, which has been published in final form at
Sponsor/Funder: Graham-Dixon Charitable Trust
Funder's Grant Number: Research Grants 2013
Keywords: 11 Medical And Health Sciences
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine

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