Roshan Bootun, Mandy Burrows, Mohammed M Chowdhury, Philip W Stather, Wissam Al-Jundi
{"title":"等待静脉曲张手术的危险。","authors":"Roshan Bootun, Mandy Burrows, Mohammed M Chowdhury, Philip W Stather, Wissam Al-Jundi","doi":"10.1177/02683555221141824","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Varicose veins (VV) negatively impact quality of life (QoL) and have risks of major complications including bleeding, ulceration and phlebitis. During the COVID-19 pandemic, the VSGBI (Vascular Society of Great Britain and Ireland) and GIRFT (Get It Right First Time) classified VVs as lowest priority for intervention.</p><p><strong>Objective: </strong>This study aims to determine harm caused and the impact on the QoL on patients waiting for their VVs procedures for more than 1 year.</p><p><strong>Methods: </strong>This was a prospective study conducted at the Norfolk and Norwich University Hospital (NNUH). Patients with VVs awaiting intervention for >1 year were included in the study. Patients with CEAP C6 disease were considered to be too high risk to be invited for treatment during the Covid-19 pandemic. Patients were sent QoL questionnaires and underwent a telephone consultation to assess harm. Both generic (EQ-VAS and EQ-5D) and disease-specific (AVVQ and CIVIQ-14) instruments were utilised. There were no control groups available for comparison.</p><p><strong>Results: </strong>275 patients were identified (37.1% male) with median time on waiting list of 60 weeks (IQR 56-65). 19 patients (6.9%) came to major harm, including phlebitis (3.6%), bleeding (1.8%) and ulceration (1.8%). Fifty-two patients (18.9%) had minor harm, including worsening pain (12.7%) and swelling (6.2%). 6.9% reported psychological harm. Rising CEAP stage was also associated with worsening level of harm in patients with C5-6 disease (<i>p</i> < 0.0001). Only 8.7% stated they would decline surgery during the pandemic. 104 QoL questionnaires were returned. Median EQ-VAS and EQ-5D was 75 (IQR: 60-85) and 0.685 (0.566-0.761), respectively. Median AVVQ score was 23.2 (14.9-31.0) and CIVIQ-14 score was 33 (21-44).ConclusionsThis study highlights the impact of delaying VVs surgery during a pandemic. A significant rate of both major and minor as well as psychological harm was reported. In addition, VVs had a significant detriment to quality of life.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 1","pages":"22-27"},"PeriodicalIF":1.6000,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713534/pdf/10.1177_02683555221141824.pdf","citationCount":"0","resultStr":"{\"title\":\"The risk of harm whilst waiting for varicose veins procedure.\",\"authors\":\"Roshan Bootun, Mandy Burrows, Mohammed M Chowdhury, Philip W Stather, Wissam Al-Jundi\",\"doi\":\"10.1177/02683555221141824\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Varicose veins (VV) negatively impact quality of life (QoL) and have risks of major complications including bleeding, ulceration and phlebitis. During the COVID-19 pandemic, the VSGBI (Vascular Society of Great Britain and Ireland) and GIRFT (Get It Right First Time) classified VVs as lowest priority for intervention.</p><p><strong>Objective: </strong>This study aims to determine harm caused and the impact on the QoL on patients waiting for their VVs procedures for more than 1 year.</p><p><strong>Methods: </strong>This was a prospective study conducted at the Norfolk and Norwich University Hospital (NNUH). Patients with VVs awaiting intervention for >1 year were included in the study. Patients with CEAP C6 disease were considered to be too high risk to be invited for treatment during the Covid-19 pandemic. Patients were sent QoL questionnaires and underwent a telephone consultation to assess harm. Both generic (EQ-VAS and EQ-5D) and disease-specific (AVVQ and CIVIQ-14) instruments were utilised. There were no control groups available for comparison.</p><p><strong>Results: </strong>275 patients were identified (37.1% male) with median time on waiting list of 60 weeks (IQR 56-65). 19 patients (6.9%) came to major harm, including phlebitis (3.6%), bleeding (1.8%) and ulceration (1.8%). Fifty-two patients (18.9%) had minor harm, including worsening pain (12.7%) and swelling (6.2%). 6.9% reported psychological harm. Rising CEAP stage was also associated with worsening level of harm in patients with C5-6 disease (<i>p</i> < 0.0001). Only 8.7% stated they would decline surgery during the pandemic. 104 QoL questionnaires were returned. Median EQ-VAS and EQ-5D was 75 (IQR: 60-85) and 0.685 (0.566-0.761), respectively. Median AVVQ score was 23.2 (14.9-31.0) and CIVIQ-14 score was 33 (21-44).ConclusionsThis study highlights the impact of delaying VVs surgery during a pandemic. A significant rate of both major and minor as well as psychological harm was reported. In addition, VVs had a significant detriment to quality of life.</p>\",\"PeriodicalId\":20139,\"journal\":{\"name\":\"Phlebology\",\"volume\":\"38 1\",\"pages\":\"22-27\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2023-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713534/pdf/10.1177_02683555221141824.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Phlebology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/02683555221141824\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Phlebology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/02683555221141824","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
摘要
简介:静脉曲张(VV)对生活质量(QoL)有负面影响，并有出血、溃疡和静脉炎等主要并发症的风险。在2019冠状病毒病大流行期间，英国和爱尔兰血管学会(VSGBI)和GIRFT (Get It Right First Time)将VVs列为干预的最低优先级。目的:本研究旨在确定等待VVs手术超过1年的患者所造成的危害及对生活质量的影响。方法:这是一项在诺福克和诺维奇大学医院(NNUH)进行的前瞻性研究。等待干预>1年的VVs患者被纳入研究。在2019冠状病毒病大流行期间，患有CEAP C6疾病的患者被认为风险太高，无法接受治疗。向患者发送生活质量问卷，并进行电话咨询以评估危害。使用通用(EQ-VAS和EQ-5D)和疾病特异性(AVVQ和CIVIQ-14)仪器。没有对照组可供比较。结果:275例患者(37.1%男性)中位等待时间为60周(IQR 56-65)。19例(6.9%)出现严重伤害，包括静脉炎(3.6%)、出血(1.8%)和溃疡(1.8%)。52例(18.9%)患者有轻微损害，包括疼痛加重(12.7%)和肿胀(6.2%)。6.9%报告有心理伤害。C5-6疾病患者CEAP分期升高也与损害程度加重相关(p < 0.0001)。只有8.7%的人表示他们会在大流行期间拒绝手术。共回收生活质量问卷104份。EQ-VAS和EQ-5D的中位数分别为75 (IQR: 60-85)和0.685(0.566-0.761)。AVVQ评分中位数为23.2 (14.9-31.0)，CIVIQ-14评分中位数为33(21-44)。本研究强调了在大流行期间延迟VVs手术的影响。据报道，严重和轻微以及心理伤害的发生率都很高。此外，VVs对生活质量也有很大的损害。
The risk of harm whilst waiting for varicose veins procedure.
Introduction: Varicose veins (VV) negatively impact quality of life (QoL) and have risks of major complications including bleeding, ulceration and phlebitis. During the COVID-19 pandemic, the VSGBI (Vascular Society of Great Britain and Ireland) and GIRFT (Get It Right First Time) classified VVs as lowest priority for intervention.
Objective: This study aims to determine harm caused and the impact on the QoL on patients waiting for their VVs procedures for more than 1 year.
Methods: This was a prospective study conducted at the Norfolk and Norwich University Hospital (NNUH). Patients with VVs awaiting intervention for >1 year were included in the study. Patients with CEAP C6 disease were considered to be too high risk to be invited for treatment during the Covid-19 pandemic. Patients were sent QoL questionnaires and underwent a telephone consultation to assess harm. Both generic (EQ-VAS and EQ-5D) and disease-specific (AVVQ and CIVIQ-14) instruments were utilised. There were no control groups available for comparison.
Results: 275 patients were identified (37.1% male) with median time on waiting list of 60 weeks (IQR 56-65). 19 patients (6.9%) came to major harm, including phlebitis (3.6%), bleeding (1.8%) and ulceration (1.8%). Fifty-two patients (18.9%) had minor harm, including worsening pain (12.7%) and swelling (6.2%). 6.9% reported psychological harm. Rising CEAP stage was also associated with worsening level of harm in patients with C5-6 disease (p < 0.0001). Only 8.7% stated they would decline surgery during the pandemic. 104 QoL questionnaires were returned. Median EQ-VAS and EQ-5D was 75 (IQR: 60-85) and 0.685 (0.566-0.761), respectively. Median AVVQ score was 23.2 (14.9-31.0) and CIVIQ-14 score was 33 (21-44).ConclusionsThis study highlights the impact of delaying VVs surgery during a pandemic. A significant rate of both major and minor as well as psychological harm was reported. In addition, VVs had a significant detriment to quality of life.
期刊介绍：
The leading scientific journal devoted entirely to venous disease, Phlebology is the official journal of several international societies devoted to the subject. It publishes the results of high quality studies and reviews on any factor that may influence the outcome of patients with venous disease. This journal provides authoritative information about all aspects of diseases of the veins including up to the minute reviews, original articles, and short reports on the latest treatment procedures and patient outcomes to help medical practitioners, allied health professionals and scientists stay up-to-date on developments.
Print ISSN: 0268-3555
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
