{"title":"静脉性腿溃疡和病态肥胖患者静脉疾病的超声模式。","authors":"Jana-Lee Moss, Matthew Pugliese, Toby Richards","doi":"10.1177/02683555221130923","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aims: </strong>Obesity affects over two-thirds of the Australian population and is associated with increased risk of venous leg ulceration (VLU). Management is challenging to both patients and staff. Surgical treatment of superficial venous incompetence in patients with VLU reduces ulcer healing time and recurrence, but this has not yet been investigated in patients with obesity. We aimed to determine in patients with VLU and morbid obesity if their ultrasound pattern of superficial venous incompetence was like those patients without morbid obesity.</p><p><strong>Methods: </strong>Consecutive patients attending the outpatient leg ulcer clinic from January to December 2019 were eligible for inclusion if they had an active or healed VLU. Age, gender, BMI, and ulcer sidedness were collected from the electronic medical record and assessed against findings of venous duplex ultrasound. Primary outcome was the proportion of patients with morbid obesity with superficial venous incompetence. Secondary outcomes included the proportion of patients with morbid obesity who were investigated with a duplex ultrasound, and any presence of deep venous incompetence.</p><p><strong>Results: </strong>Of 231 patients that attended 156 were eligible for inclusion. 103 patients had full data and were used for the primary outcome analysis. There were 29 patients (28.2%) with morbid obesity. They were younger than those without morbid obesity (69.0 vs 73.0 years, <i>p</i> .026) with no difference in gender, active or healed ulcer classification (CEAP C5/6), or ulcer sidedness. We found no difference in the proportion of patients with morbid obesity with superficial venous incompetence on ultrasound (72.4% vs 79.7%, <i>p</i>.423). Patients with morbid obesity were equally as likely to undergo ultrasound investigation (73.2% vs 75.8%, <i>p</i>.748).</p><p><strong>Conclusions: </strong>In patients with VLU there appeared no difference in the proportion of patients with morbid obesity with superficial venous incompetence. Directed studies are needed to determine the effectiveness of intervention in this patient population.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Ultrasound patterns of venous disease in patients with venous leg ulcers and morbid obesity.\",\"authors\":\"Jana-Lee Moss, Matthew Pugliese, Toby Richards\",\"doi\":\"10.1177/02683555221130923\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aims: </strong>Obesity affects over two-thirds of the Australian population and is associated with increased risk of venous leg ulceration (VLU). Management is challenging to both patients and staff. Surgical treatment of superficial venous incompetence in patients with VLU reduces ulcer healing time and recurrence, but this has not yet been investigated in patients with obesity. We aimed to determine in patients with VLU and morbid obesity if their ultrasound pattern of superficial venous incompetence was like those patients without morbid obesity.</p><p><strong>Methods: </strong>Consecutive patients attending the outpatient leg ulcer clinic from January to December 2019 were eligible for inclusion if they had an active or healed VLU. Age, gender, BMI, and ulcer sidedness were collected from the electronic medical record and assessed against findings of venous duplex ultrasound. Primary outcome was the proportion of patients with morbid obesity with superficial venous incompetence. Secondary outcomes included the proportion of patients with morbid obesity who were investigated with a duplex ultrasound, and any presence of deep venous incompetence.</p><p><strong>Results: </strong>Of 231 patients that attended 156 were eligible for inclusion. 103 patients had full data and were used for the primary outcome analysis. There were 29 patients (28.2%) with morbid obesity. They were younger than those without morbid obesity (69.0 vs 73.0 years, <i>p</i> .026) with no difference in gender, active or healed ulcer classification (CEAP C5/6), or ulcer sidedness. We found no difference in the proportion of patients with morbid obesity with superficial venous incompetence on ultrasound (72.4% vs 79.7%, <i>p</i>.423). Patients with morbid obesity were equally as likely to undergo ultrasound investigation (73.2% vs 75.8%, <i>p</i>.748).</p><p><strong>Conclusions: </strong>In patients with VLU there appeared no difference in the proportion of patients with morbid obesity with superficial venous incompetence. 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引用次数: 1
摘要
背景/目的:肥胖影响了超过三分之二的澳大利亚人口,并与腿部静脉溃疡(VLU)的风险增加有关。管理对病人和工作人员都是一项挑战。手术治疗浅表静脉功能不全的VLU患者可减少溃疡愈合时间和复发,但尚未对肥胖患者进行研究。我们的目的是确定VLU和病态肥胖患者的浅静脉功能不全的超声模式是否与没有病态肥胖的患者相似。方法:2019年1月至12月在门诊腿部溃疡诊所连续就诊的患者,如果他们有活动或愈合的VLU,则符合纳入条件。从电子病历中收集年龄、性别、BMI和溃疡程度,并根据静脉双工超声检查结果进行评估。主要终点是伴有浅表静脉功能不全的病态肥胖患者的比例。次要结局包括用双工超声检查的病态肥胖患者的比例,以及任何深静脉功能不全的存在。结果:231例患者中有156例符合纳入条件。103例患者有完整的数据,并用于主要结果分析。29例(28.2%)为病态肥胖。他们比没有病态肥胖的人年轻(69.0岁vs 73.0岁,p .026),在性别、活跃或愈合的溃疡分类(CEAP C5/6)或溃疡侧面性方面没有差异。我们发现,在超声检查中,伴有浅表静脉功能不全的病态肥胖患者的比例没有差异(72.4% vs 79.7%, p.423)。病态肥胖患者同样可能接受超声检查(73.2% vs 75.8%, p.748)。结论:在VLU患者中,伴有浅表静脉功能不全的病态肥胖患者比例无显著差异。需要有针对性的研究来确定干预在这一患者群体中的有效性。
Ultrasound patterns of venous disease in patients with venous leg ulcers and morbid obesity.
Background/aims: Obesity affects over two-thirds of the Australian population and is associated with increased risk of venous leg ulceration (VLU). Management is challenging to both patients and staff. Surgical treatment of superficial venous incompetence in patients with VLU reduces ulcer healing time and recurrence, but this has not yet been investigated in patients with obesity. We aimed to determine in patients with VLU and morbid obesity if their ultrasound pattern of superficial venous incompetence was like those patients without morbid obesity.
Methods: Consecutive patients attending the outpatient leg ulcer clinic from January to December 2019 were eligible for inclusion if they had an active or healed VLU. Age, gender, BMI, and ulcer sidedness were collected from the electronic medical record and assessed against findings of venous duplex ultrasound. Primary outcome was the proportion of patients with morbid obesity with superficial venous incompetence. Secondary outcomes included the proportion of patients with morbid obesity who were investigated with a duplex ultrasound, and any presence of deep venous incompetence.
Results: Of 231 patients that attended 156 were eligible for inclusion. 103 patients had full data and were used for the primary outcome analysis. There were 29 patients (28.2%) with morbid obesity. They were younger than those without morbid obesity (69.0 vs 73.0 years, p .026) with no difference in gender, active or healed ulcer classification (CEAP C5/6), or ulcer sidedness. We found no difference in the proportion of patients with morbid obesity with superficial venous incompetence on ultrasound (72.4% vs 79.7%, p.423). Patients with morbid obesity were equally as likely to undergo ultrasound investigation (73.2% vs 75.8%, p.748).
Conclusions: In patients with VLU there appeared no difference in the proportion of patients with morbid obesity with superficial venous incompetence. Directed studies are needed to determine the effectiveness of intervention in this patient population.
期刊介绍:
The leading scientific journal devoted entirely to venous disease, Phlebology is the official journal of several international societies devoted to the subject. It publishes the results of high quality studies and reviews on any factor that may influence the outcome of patients with venous disease. This journal provides authoritative information about all aspects of diseases of the veins including up to the minute reviews, original articles, and short reports on the latest treatment procedures and patient outcomes to help medical practitioners, allied health professionals and scientists stay up-to-date on developments.
Print ISSN: 0268-3555