Trends of hospital-based surgery for varicose veins in the elderly

Kim, Tanner; Zhang, Yawei; Guzman, Raul J.; Chaar, Cassius Iyad Ochoa

doi:10.1016/j.jvsv.2020.04.016

Cited by 9 publications

(11 citation statements)

References 33 publications

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“…17 There has been a particular growth in the treatment of the elderly, presumably due out the improved benefit-risk ratio for endothermal procedures. 18 Elderly patients are also more likely to be treated for venous ulceration and more severe disease in general.…”

Section: Discussionmentioning

confidence: 99%

An algorithm combining VVSYmQ^® and VCSS scores may help to predict disease severity in C2 patients

et al. 2021

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Objectives The purpose was to assess whether combining patient reported scores (VVSymQ®) and physician reported scores (VCSS) stratifies disease severity in C2 patients. Methods Consecutive patients were pooled from the VANISH-1 and VANISH-2 cohorts. VCSS and VVSymQ® were calculated for each patient. The relationship between scoring systems was evaluated using Pearson’s correlation and frequency distribution analysis. Results Two-hundred and ten C2 limbs were included. Scoring systems demonstrated: VVSymQ®: mean = 8.72; VCSS: mean = 6.32; correlation (r = 0.22, p = 0.05). Frequency distribution analysis demonstrated 61.4% of patients had low VVSymQ® and low VCSS; 31.3% had elevated VVSymQ® and increased VCSS; 7.3% were inconsistent with C2 disease. Strict concordance analysis revealed 40.5% had VVSymQ® (< 9)/VCSS (0-6), 18.6% had VVSymQ® (≥ 9)/VCSS (7-9), and 2.9% had VVSymQ® (≥9)/VCSS (≥10). Conclusions For combined elevated VVSymQ® and VCSS, moderate/severe disease is corroborated, and intervention may be indicated. For combined lower scores, the disease severity is mild and conservative therapy is more appropriate.

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Section: Discussionmentioning

confidence: 99%

An algorithm combining VVSYmQ^® and VCSS scores may help to predict disease severity in C2 patients

et al. 2021

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“…To our knowledge, the only other population-based study for comparison was the one evaluating the data from Portuguese public hospitals, with an in-hospital mortality rate of 0.015% [22]. The other population-based studies that assessed deaths following CVD surgeries evaluated 30-day mortality [20,21]. The mortality rate for CVD surgeries in Portugal was three-fold higher.…”

Section: Discussionmentioning

confidence: 99%

“…Still regarding mortality assessment, some limitations of our study are noteworthy. As our data are anonymous, we do not know the causes of death and followup is not possible, therefore, deaths after discharge were missed, and we are unable to calculate 30-day mortality, as performed in Japan [20] and USA [21]. Consequently, we may be observing more deaths related to anesthetics and bleeding complications and perhaps missing some pulmonary embolism-related deaths.…”

Section: Discussionmentioning

confidence: 99%

“…In Japan, the Japanese Society for Vascular Surgery [20] registered 41,246 surgeries for the treatment of CVD in 2014, with a zero 30-day mortality. In the USA, according to the American College of Surgeons -Quality Improvement Program [21], a total of 48,615 surgeries for CVD was performed between 2005 and 2017, with a 30-day mortality rate of 0.02%. In Portugal, 153,382 patients underwent surgery to treat CVD in public hospitals between 2004 and 2016, with an in-hospital mortality rate of 0.015% [22].…”

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confidence: 99%

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Epidemiology of 869,220 varicose vein surgeries over 12 years in Brazil: trends, costs and mortality rate

Silva

Louzada

Silva

et al. 2021

Preprint

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Objectives: to assess the total numbers of surgical procedures performed between 2008 and 2019 for the treatment of varicose veins in the Public Health System, which exclusively insures more than 160 millions Brazilian, the distribution of the surgeries over time, as well as its costs and mortality rates. Design, Materials and Methods: data referring to surgeries to treat chronic venous disease between 2008 and 2019 were extracted from the database of the Brazilian Public Health System. Results: In total, 869,220 surgeries were performed to treat chronic venous disease in public hospitals and outpatient clinics in Brazil, with an average rate of 4,52 surgeries per 10,000 inhabitants per year. From 2015 on, we observe a slight downward trend in the total number of procedures. The total amount reimbursed by the government was US$ 266,628,181.69. A total of 49 deaths were registered following varicose vein surgery, corresponding to a mortality rate of 0.005%. Conclusions: a total of 869,220 surgeries were performed to treat varicose in twelve years, with an overall rate of 4.52 procedures per 10,000 inhabitants per year. The mortality rate was very low, 0.005%.

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“…En ciertas circunstancias se requiere combinar la terapia ablativa con cirugía convencional (tratamiento híbrido). Las técnicas ablativas con láser y radiofrecuencia tienen menos tasas de complicaciones por la mínima manipulación, pueden presentar otras complicaciones relacionadas a la energía termal, como la trombosis inducida por calor endotérmico y la lesión de nervio por lesión termal o la aplicación de anestesia tumescente (17)(18)(19)(20)(21) . En ese sentido la polimerización de la vena insuficiente con cianocrilato (terapia no ablativa) evita esos riesgos y es de gran ventaja para la población de pacientes adultos mayores.…”

Section: Tratamiento Quirúrgico Y Endovenosounclassified

Insuficiencia venosa crónica en el adulto mayor

Cadena

2022

Rev Med Hered

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La insuficiencia venosa crónica (IVC) es una patología vascular frecuente en el adulto mayor, y genera dificultades en su diagnóstico y tratamiento debido a la presencia de comorbilidades. Se realizó una revisión narrativa a partir de la búsqueda en cinco bases de datos: PubMed, Scielo, Lilacs, Clinical Key (Elsevier) y Ebsco. En la población geriátrica se presentan estadios más severos de la enfermedad, como el edema y los cambios tróficos en la pierna, debido a la preexistencia de enfermedad venosa crónica. Los principales factores de riesgo de progresión de la enfermedad son la obesidad, la movilidad limitada y las comorbilidades. El diagnóstico se basa en la sospecha clínica y su confirmación con eco Doppler venoso de miembros inferiores. En el diagnóstico diferencial debe considerarse causas sistémicas de edema de miembros inferiores como la insuficiencia cardíaca, disfunción renal o hepática, y el uso de medicamentos hipertensivos. Otros diagnósticos diferenciales son linfedema, trombosis venosa subclínica, y dolor crónico de miembros inferiores. El tratamiento incluye la educación del paciente, medias de compresión, tratamiento médico y quirúrgico. En conclusión, la insuficiencia venosa crónica es una enfermedad frecuente y de mayor severidad en los pacientes de edad avanzada. La obesidad, la poca movilidad y las comorbilidades son los factores de riesgo asociados a la progresión de la enfermedad. La educación del paciente, el uso de medias de compresión y la terapia con flebotónicos son eficaces en el tratamiento. El tratamiento quirúrgico / endovenoso tiene buena efectividad en paciente de edad avanzada que padecen de IVC.

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Trends of hospital-based surgery for varicose veins in the elderly

Cited by 9 publications

References 33 publications

An algorithm combining VVSYmQ^® and VCSS scores may help to predict disease severity in C2 patients

An algorithm combining VVSYmQ^® and VCSS scores may help to predict disease severity in C2 patients

Epidemiology of 869,220 varicose vein surgeries over 12 years in Brazil: trends, costs and mortality rate

Insuficiencia venosa crónica en el adulto mayor

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Trends of hospital-based surgery for varicose veins in the elderly

Cited by 9 publications

References 33 publications

An algorithm combining VVSYmQ® and VCSS scores may help to predict disease severity in C2 patients

An algorithm combining VVSYmQ® and VCSS scores may help to predict disease severity in C2 patients

Epidemiology of 869,220 varicose vein surgeries over 12 years in Brazil: trends, costs and mortality rate

Insuficiencia venosa crónica en el adulto mayor

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Product

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An algorithm combining VVSYmQ^® and VCSS scores may help to predict disease severity in C2 patients

An algorithm combining VVSYmQ^® and VCSS scores may help to predict disease severity in C2 patients