Effect of obesity on chronic venous insufficiency treatment outcomes
Effect of obesity on chronic venous insufficiency treatment outcomes
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DOI：
10.1016/j.jvsv.2020.04.006
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发表时间：
2020-07-01
影响因子：
3.2
通讯作者：
Pappas, Peter J.
中科院分区：
文献类型：
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作者：
Deol, Zoe K.;Lakhanpal, Sanjiv;Pappas, Peter J.
背景：肥胖是慢性静脉疾病（CVD）发生和进展的已知危险因素。目前尚不清楚心血管疾病干预后的治疗结局是否受肥胖的影响。本调查的目的是评估各种CVD治疗肥胖患者的有效性，并确定什么水平的肥胖与不良outcomes.Methods：数据前瞻性地收集在中心静脉恢复电子病历系统（NexGen医疗信息系统，欧文，加利福尼亚州）和回顾性分析。患者和肢体按以下体重指数（BMI）分类：46 kg/m（2）。修订的静脉临床严重程度评分和慢性静脉功能不全生活质量问卷20项的变化（CIVIQ-20）生活质量调查用于确定接受静脉内热消融（TA）、静脉切除术或超声引导泡沫硬化疗法（USGFS）的患者的CVD治疗效果。从2015年1月至2017年12月，65，329名患者（77%女性; 23%男性）接受了静脉手术。在这些患者中，25，592例（39，919条肢体）接受了单独消融、消融伴静脉切除术或消融伴静脉切除术和USGFS。进行的手术数量如下：TA，n = 37，781; USGFS，n = 22，964;静脉切除术，n = 17，467。对于接受TA的患者，术后6个月时的改善程度随着BMI的增加而逐渐降低，BMI >35 kg/m2的患者的改善程度更明显（P = 35 kg/m2），BMI >= 46 kg/m2的患者观察到的结果最差（P
Background: Obesity is a known risk factor for the development and progression of chronic venous disorders (CVDs). It is currently unknown whether the treatment outcomes, after an intervention for CVDs, are affected by obesity. The purpose of the present investigation was to assess the effectiveness of various CVD treatments in obese patients and determine what level of obesity is associated with poor outcomes.Methods: Data were prospectively collected in the Center for Vein Restoration electronic medical record system (NexGen Healthcare Information System, Irvine, Calif) and retrospectively analyzed. The patients and limbs were categorized by the following body mass index (BMI) categories: 46 kg/m(2). The changes in the revised venous clinical severity score and Chronic Venous Insufficiency Quality of Life Questionnaire 20-item (CIVIQ-20) quality of life survey were used to determine the CVD treatment effectiveness for patients who had undergone endovenous thermal ablation (TA), phlebectomy, or ultrasound-guided foam sclerotherapy (USGFS).Results: From January 2015 to December 2017 ,65,329 patients (77% female; 23% male) had undergone a venous procedure. Of these patients, 25,592 (39,919 limbs) had undergone ablation alone, ablation with phlebectomy, or ablation with phlebectomy and USGFS. The number of procedures performed was as follows: TA, n = 37,781; USGFS, n = 22,964; and phlebectomy, n = 17,467. The degree of improvement at 6 months after the procedure was progressively less with an increasing BMI for the patients who had undergone TA, and the decrease was more significant for those patients with a BMI >35 kg/m(2) (P = 35 kg/m(2), with the poorest outcomes observed in patients with a BMI >= 46 kg/m(2) (P