Severe Chronic Venous Insufficiency: Magnitude of the Problem and Consequences
dc.contributor.author | Tsai, Susan | en_US |
dc.contributor.author | Upchurch, Gilbert R. | en_US |
dc.contributor.author | Henke, Peter K. | en_US |
dc.contributor.author | Dubovoy, Anna | en_US |
dc.contributor.author | Wakefield, Thomas W. | en_US |
dc.contributor.author | Wainess, Reid M. | en_US |
dc.date.accessioned | 2006-09-08T19:10:58Z | |
dc.date.available | 2006-09-08T19:10:58Z | |
dc.date.issued | 2005-09 | en_US |
dc.identifier.citation | Tsai, Susan; Dubovoy, Anna; Wainess, Reid; Upchurch, Gilbert R.; Wakefield, Thomas W.; Henke, Peter K.; (2005). "Severe Chronic Venous Insufficiency: Magnitude of the Problem and Consequences." Annals of Vascular Surgery 19(5): 705-711. <http://hdl.handle.net/2027.42/41369> | en_US |
dc.identifier.issn | 1615-5947 | en_US |
dc.identifier.issn | 0890-5096 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/41369 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=16034514&dopt=citation | en_US |
dc.description.abstract | The aim of this study was to characterize patients requiring hospitalization for severe chronic venous insufficiency (CVI) at the local and national levels and to analyze factors related to primary amputation. An administrative database (Nationwide Inpatient Sample, 1988-2000) and a single institution (1992-2000) were reviewed using the International Classification of Diseases, 9th ed., Clinical Modification , codes for CVI, excluding phlegmasia and concomitant peripheral vascular occlusive disease codes. Demographics, clinical course, and outcomes were assessed. Descriptive, univariate, and multivariate statistical analyses were used; p < 0.05 was considered significant. Nationally, CVI occurred with a mean incidence of 92/100,000 admissions, of which 55% were women, having a mean age of 65 years and a median length of stay of 7 days. Mean hospital charges were $13,900 and did not change significantly over time. Acute deep vein thrombosis affected 1.3%, amputation was performed in 1.2%, and in-hospital mortality was 1.6% The local cohort included 67 patients with a mean age of 51 years; a majority were men (60%), and 85% were C6 (of Clinical-Etiologic-Anatomic-Pathophysiology [CEAP]). Patients averaged 23 clinic visits and a median of one hospitalization for CVI care over a 44-month follow-up. Twelve patients (18%) underwent a CVI-related amputation (one transmetatarsal amputation, nine below-knee amputations, and two above-knee amputations). They had fourfold more CVI-related hospitalizations, greater preoperative chronic narcotic use than nonamputee patients (85% vs. 58%), but less ongoing wound care needs (25% vs. 89%) (all p values < 0.05). However, no significant difference in long-term mortality, number of clinic visits, duration of symptoms, antibiotic courses, or prior venous-related surgeries was found. In those with amputation, ambulatory status was maintained in 75% at 15-month follow-up. The physiological and economic costs of severe CVI are significant and have not decreased over more than a decade. Amputation for CVI-related nonhealing wounds has a reasonable outcome. Future therapy must focus on prevention of CVI sequelae. | en_US |
dc.format.extent | 118842 bytes | |
dc.format.extent | 3115 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.language.iso | en_US | |
dc.publisher | Springer-Verlag; Annals of Vascular Surgery Inc. | en_US |
dc.subject.other | Medicine & Public Health | en_US |
dc.subject.other | Abdominal Surgery | en_US |
dc.title | Severe Chronic Venous Insufficiency: Magnitude of the Problem and Consequences | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Surgery and Anesthesiology | en_US |
dc.subject.hlbsecondlevel | Radiology | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Section of Vascular Surgery, Department of Surgery, University of Michigan, School of Medicine, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Section of Vascular Surgery, Department of Surgery, University of Michigan, School of Medicine, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Section of Vascular Surgery, Department of Surgery, University of Michigan, School of Medicine, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Section of Vascular Surgery, Department of Surgery, University of Michigan, School of Medicine, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Section of Vascular Surgery, Department of Surgery, University of Michigan, School of Medicine, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Section of Vascular Surgery, Department of Surgery, University of Michigan, School of Medicine, Ann Arbor, MI; University of Michigan Health System, 1500 East Medical Center Drive, 2210 Taubman Health Care System, Ann Arbor, MI, 48109-0329 | en_US |
dc.contributor.affiliationumcampus | Ann Arbor | en_US |
dc.identifier.pmid | 16034514 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/41369/1/10016_2005_Article_5425.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1007/s10016-005-5425-8 | en_US |
dc.identifier.source | Annals of Vascular Surgery | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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