Socioeconomic Status and Clinical Stage of Patients Presenting for Treatment of Varicose Veins
Rteil A, Lin J, Weaver M, Ahsan S, Lee A, and Kabbani L. Socioeconomic Status and Clinical Stage of Patients Presenting for Treatment of Varicose Veins. J Vasc Surg-Venous L 2020; 8(2):328.
J Vasc Surg-Venous L
Objective: The association between socioeconomic status (SES) and chronic venous insufficiency has not been rigorously studied. This study aimed to determine the influence of SES on the clinical stage of patients presenting for chronic venous disease therapy. Methods: By use of the local Vascular Quality Initiative Varicose Vein Registry at our tertiary referral center, all patients undergoing therapy for varicose veins between January 2015 and June 2019 were queried. SES was quantified using the Neighborhood Deprivation Index (NDI). This is a standardized and reproducible index used in research that summarizes eight domains of socioeconomic deprivation. It is based on census tract data derived from the patients’ addresses at the time of the operation. The higher the number, the worse the patients’ SES is. The association between SES and severity of the vein disease at presentation was studied with bivariate analysis of variance and linear regression analysis. Results: A total of 449 patients had complete SES and Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) class data and were included in the study. The mean age was 58 years; 67% were female, and 60% were white. CEAP class included the following: C2, 22%; C3, 50%; C4, 15%; C5, 5%; and C6, 8%. The average NDI was 0.03 (minimum, −1.45; maximum, 2.89). There was a linear correlation between the CEAP class at presentation and the NDI (P <.05; Fig). SES was not associated with history of deep venous thrombosis, prior vein treatment, use of compression therapy, or Venous Clinical Severity Score. Conclusions: CEAP class at presentation for treatment of chronic venous disease is associated with SES. This may reflect that patients with a lower SES wait longer before seeking medical therapy for venous disease.