CLINICAL PREDICTORS OF THE SEVERITY OF CHRONIC VENOUS INSUFFICIENCY OF THE LOWER-LIMBS - A MULTIVARIATE-ANALYSIS

Introduction: Chronic venous insufficiency (CVI) affects a large propo rtion of individuals and, with the ageing of the Western European popu lation, its prevalence is bound to increase. Epidemiological data, par ticularly regarding risk factors, are scarce and controversial. Object ive: Identification of clinical factors associated with an increase in severity of CVI. Setting: Community-based study of patients presentin g to their general practitioner. Methods: Four hundred and seventy-fou r unselected patients with symptoms suggesting CVI were evaluated by 1 8 general practitioners. CVI was diagnosed and assessed by clinical ex amination and portable continuous-wave Doppler. Severity of CVI was gr aded according to the nomenclature of the International Society for Ca rdiovascular Surgery. Patient demographic and clinical factors showing a linear relationship with the severity of CVI were analysed with the proportional odds model to evaluate the simultaneous effect of severa l factors in the severity of CVI. Results: A multivariate model is pro posed, where age is a major risk factor for increased severity. Other factors that are independently correlated with the severity of CVI are body weight, environmental heat, sedentarity, CVI in both parents, hi gh-dose oestrogen formulations, osteoarticular disease of the lower li mbs, presence of truncal varices, involvement of the internal saphena, lymphoedema and history of thrombophlebitis. Conclusion: Because most studies do not adjust for age when testing for risk factors, this may be an important reason for the multiplicity of reported factors and t he lack of consistency of their results.