Incidence of Recurrent Venous Ulcer in Patients Treated at an Outpatient Clinic: Historical Cohort

Abstract

The recurrence of venous ulcers is the wound reopening after a period of completed epithelisation of a previous ulcer due to exposure to causal factors and lack of prevention. Venous ulcers have a high recurrence rate that may increase through the years. Epidemiological evidence on its incidence and risk factors is scarce due to the lack of patient follow-up in outpatient clinics and adherence to treatment after healing. The objective was to analyze the incidence of venous ulcers recurrency in outpatients and the risk factors for its occurrence. It is an observational historical cohort with retrospective data collection, performed through electronic medical records. Setting: private health insurance outpatient clinic. The participants were adult patients with healed venous ulcers. Incidence of venous ulcer recurrence was calculated within individuals with healed ulcers from 2014 and 2018 with a follow-up of at least one year. Bivariate analysis and logistic regression were used to explore risk factors considering demographic, clinical, and wound-related variables. As a result, sixty-five (65) of the 134 patients with healed venous ulcers had a recurrence, leading to an incidence of 48.5%, with a mean onset time of 230.1 (SD 267) days. Patients with recurrent venous ulcers were primarily women (39/48.1%), with a mean age of 64 (SD 15.5) years, 57 (50.8%) had some comorbidity, with systemic arterial hypertension as the most frequent (47/51%). Obesity (15/88.2%) increased the risk of venous ulcers recurrence by 8.7 (OR 95% CI 2.1-60.8; P = .009) times. In conclusion, venous ulcers recurrence incidence was 48.5%, with obesity as a risk factor. This study demonstrates that the clinical approach of people with venous ulcers should not finish when the wound is healed. For ulcer recurrence prevention interventions addressing systemic factors, besides topical management of the wound, are essential.

Telenursing to Patients With Venous Ulcers: Guidelines Provided and Outcome of Remote Monitoring

“…In an observational historical cohort carried out at a stomatherapy center in the city of São Paulo, it was revealed that recurrent VUs in the legs were identified mainly in women aged 60 years or older, obese, hypertensive and diabetic; the incidence of recurrence of VUs in the legs of patients with this profile identified in an outpatient clinic is 48.5%. Another critical factor in the results demonstrated that obesity increased by 8.7 times the chances of patients with healed ulcers having an ulcer recurrence 24 .…”

Bacterial Species Involved in Venous Leg Ulcer Infections and Their Sensitivity to Antibiotherapy—An Alarm Signal Regarding the Seriousness of Chronic Venous Insufficiency C6 Stage and Its Need for Prompt Treatment

“…Common risk factors for VLU occurrence, such as the female gender, being elderly, and having obesity, also seem to be involved in recurrence occurrence. For example, obesity increases, by 8.7 times, the risk of recurrence [ 14 ]. Also, some comorbidities, such as systemic arterial hypertension, can bring an additional risk.…”

Telenfermagem a Pacientes Com Úlceras Venosas: Orientações Fornecidas E Desfecho Do Monitoramento Remoto

“…Em coorte histórica observacional realizada em um centro de estomaterapia na cidade de São Paulo, revelou-se que as UVs recorrentes nas pernas foram identificadas principalmente em mulheres com 60 anos ou mais, obesas, hipertensas e diabéticas; é de 48,5% a incidência de recorrência de UVs nas pernas de pacientes com esse perfil identificados em ambulatório. Outro fator importante nos resultados demonstrou que a obesidade aumentou em 8,7 vezes as chances de os pacientes com úlceras curadas terem uma recorrência da úlcera 24 .…”