Correlation of age with patient reported symptoms and venous clinical severity score for patients with varicose veins.
Leonard-Murali S, McLaughlin D, Kabbani L, Weaver MR, Kennedy N, Ahsan S, and Lin JC. Correlation of age with patient reported symptoms and venous clinical severity score for patients with varicose veins. J Vasc Surg 2018; 67(6):e229.
J Vasc Surg
Objectives: Previously published data demonstrated that elderly patients older than age 65 benefit from vein ablation procedures. The objective of this study is to compare young, middle-aged, and older patients who underwent varicose vein ablation using our institutional Vascular Quality Initiative Varicose Vein Registry (VQI VVR). Methods: Retrospective analysis of a prospective registry of all vein procedures in the VQI VVR was performed from January 2015 to August 2017 at our tertiary care institution. We divided all patients into three groups depending on their age at presentation: young (group A, age <45), middle (group B, age 45-64), and old (group C, age >65). Comparison data included patient demographics, past medical history, clinical outcomes, patient reported outcomes, and postoperative complications. Clinical outcomes were assessed by the clinical, etiology, anatomy, and pathophysiology (CEAP) classification and venous clinical severity score (VCSS). Patient reported outcomes were assessed by heaviness, achiness, swelling, throbbing, itching (HASTI) symptoms and their impact on work and activity. Statistical testing included c2 test for categorical variables and student t-test for continuous variables using SPSS statistical software. Results: There were a total of 1035 procedures performed during the study period: 133 patients were age <45 (group A), 559 were age 45 to 64 (group B), and 342 were age >65 (group C). Majority of the vein procedures were for truncal vein reflux and more than two-third were females across all age groups. VCSS scores were significantly higher for the older age groups (Table). HASTI scores were significantly lower for the older age groups when compared with the younger group (Table). Younger patients (group A) had more commercial insurance (P < .001), less anticoagulation use (P < .001). There was no significant difference between the groups in terms of positive history for superficial phlebitis, DVT, or prior varicose vein procedure. (Table presented) Conclusions: While older patients present with higher VCSS scores, the younger patients report significantly higher HASTI scores. Our findings support that patients with advanced age have a higher venous disease clinical severity score upon presentation for vein treatment. However, the younger population report more symptoms. Further study may elucidate why the younger population tends to report higher HASTI symptoms despite having lower VCSS scores.