LONG-TERM PROGNOSIS FOR PATIENTS WITH CHRONIC LEG ULCERS - A PROSPECTIVE COHORT STUDY

Objectives: To assess the long-term prognosis of leg ulcers. Design: A 5 year prospective cohort study. Materials: A random sample of 382 pa tients with open leg ulcers (foot ulcers included) treated in the comm unity. Methods: Interim analyses were made at 15 months (arterial ulce rs) and at 20 months (varicose ulcers). Long-term healing was assessed at 54 months by a postal questionnaire. Five year survival was assess ed by official population registries. Results: At 54 months 212 patien ts (55%) were still alive, of whom 124 (58%) had healed their ulcers, 80 (38%) had open ulcers and eight (4%) were amputated. The healing wa s worst for patients with venous ulcers, only 44% had healed their ori ginal ulcers without recurrence. The 5 year survival was 52%, signific antly lower than for age- and sex-matched controls (68%) (p=0.0002). P atients with venous ulcers had a survival not significantly different from controls and patients with arterial or other aetiologies had a do ubled risk of death. Diabetic patients had a lower survival than nondi abetics (p<0.05) and controls (p<0.0001), but the healing prognosis wa s not significantly different. Conclusion: Only patients with non-veno us ulcers have a higher mortality than expected. The long-term healing prognosis for leg ulcer patients is poor and worst for patients with venous ulcers.