Authors
Mnatsakanyan G.V.1, Shirinbek О.1, Odinokova S.N.1, 2
1 «SM-Clinic» Multiprofile Medical Holding, Moscow
2 I.M. Sechenov First Moscow State Medical University, Moscow
Abstract
Aim. Assessment of the quality of life in patients with varicose veins of the lower extremities using the VEINES-QoL/Sym questionnaire immediately before and 3 months after cyanoacrylate adhesive closure (CAC).
Materials and methods. The study included 690 patients with chronic venous disease (CVD) of class C2–C6 according to CEAP, who underwent CAC using the VenaSeal method. The patients were divided into several groups depending on their gender, age, BMI and educational level. The inclusion criteria were the presence of CVD C2–C6 CEAP classes, junctional incompetence of the truncal saphenous veins, the presence of axial reflux lasting more than 0.5 seconds, the absence of previous open surgical interventions and any types of endovenous ablation for varicose veins, the absence of a history of deep vein thrombosis of the lower extremities. The exclusion criteria were: the presence of advanced peripheral arterial disease, osteoarthritis of the hip and/or knee, sciatica. All patients, with their informed consent, were asked to answer the VEINES-QoL/Sym instrument questions on the day of the procedure and after 3 months. STATISTICA 10.0 software was used for statistical analysis. The results were statistically significant at p<0.05.
Results. Statistically significant improvement in the quality of life after the procedure was observed in all comparison groups differentiated by patients’ CEAP class, gender, BMI and educational level. The differences between the groups were statistically significant in all cases. The mean improvement in group C3 was 22 points, which is about 1.5 times more than in group C2 (+15 points). In the group of C4 patients, an improvement in the quality of life was noted by an average of 32 points, which is almost 2 times more than in C5 patients (+17 points). In the group of C6 patients, the quality of life improvement was noted at an average level of +12 points compared to the baseline. Statistically significant improvement in quality of life was observed in both groups of patients differentiated by gender (p<0.05). Meanwhile, there were no significant differences between these groups when comparing the initial values of the quality of life on the VEINES QoL/Sym scale. The improvement in the women’s group averaged +22 points, which is slightly lower than in the men’s group (+24 points). The improvement in the group of overweight patients averaged 23 points, which is higher than in the group of patients with a BMI<25 (13 points), p<0.05. Statistically significant improvement in the quality of life was also observed in all groups of patients differentiated by level of education. The improvement in the quality of life in the group of patients with secondary education averaged +32 points and did not significantly differ statistically from the group of patients with higher education (+17 points).
Conclusions. The VEINES-QoL/Sym questionnaire is a useful and convenient tool for assessing the quality of life of patients who have undergone intervention for varicose veins. The possibility of using the VEINES instrument depending on the variable criteria for dividing patients into groups is quite attractive and interesting. The structure of the studied parameters of the quality of life in the VEINES-QoL/Sym questionnaire indicates a predominant emphasis on clinical signs and symptoms as well as the physical component of health and less affects the psycho-emotional and social components. The VEINES-QoL/Sym measurement showed a statistically significant improvement in the quality of life of patients after glue ablation of varicose veins.
Keywords: varicose veins, quality of life assessment, VEINES-QoL/Sym, cyanoacrylate adhesive closure, glue ablation.
References
1. Rabe E, Guex JJ, Puskas A, Scuderi A, Fernandez Quesada F; VCP Coordinators. Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol. 2012; 31(2): 105-15.
2. Klinicheskie rekomendacii Associiacii flebologov Rossii «Varikoznoe rasshirenie ven nizhnih konechnostej», 2024. (In Russ.)
3. Zabolevaemost’ vsego naselenija Rossii v 2021 godu: statisticheskie materialy/ E. G. Kotova, O. S. Kobjakova, G. A. Aleksandrova [i dr.]. Tom Chast’ II. – Moskva : Central’nyj nauchno-issledovatel’skij institut organizacii i informatizacii zdravoohranenija, 2022. – 146 s. (In Russ.) doi: 10.21045/ 978-5-94116-072-3-2022.
4. Ware JE Jr, Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol. 1998; 51(11): 903-12. doi: 10.21045/978-5-94116-072-3-2022.
5. Shirinbek O. Evaluating the quality of life of patients with varicose veins of lower limbs following endovenous. Bulletin of Pirogov National Medical & Surgical Center.2023; 18(4): 27-31. (In Russ.) doi: 10.25881/20728255_2023_18_4_27.
6. Lamping DL, Schroter S, Kurz X, Kahn SR, Abenhaim L. Evaluation of outcomes in chronic venous disorders of the leg: development of a scientifically rigorous, patient-reported measure of symptoms and quality of life. J Vasc Surg. 2003; 37(2): 410-9. doi: 10.1067/mva.2003.152. PMID: 12563215.
7. Lamping DL, Schroter S. VEINES-QOL/VEINES-SYM Scoring Manual. London: London School of Hygiene & Tropical Medicine; 2007.
8. Abenhaim L, Kurz X. The VEINES study (VEnous Insufficiency Epidemiologic and Economic Study): an international cohort study on chronic venous disorders of the leg. VEINES Group. Angiology. 1997; 48(1): 59-66. doi: 10.1177/000331979704800110. PMID: 8995345.
9. Satybaldyeva MA, Seredavkina NV, Glukhova SI, et al. Validation of a Russian-language version of the VEINES-QOL/Sym questionnaire in patients with rheumatic diseases and lower extremity chronic venous diseases. Nauchno-Prakticheskaya Revmatologiya. 2017; 55(5): 514-520. (In Russ.) doi: 10.14412/1995-4484-2017-514-520.
10. Méan M, Limacher A, Kahn SR, Aujesky D. The VEINES-QOL/Sym questionnaire is a reliable and valid disease-specific quality of life measure for deep vein thrombosis in elderly patients. Qual Life Res. 2014; 23(9): 2463-71. doi: 10.1007/s11136-014-0704-x.
11. Kahn SR, Lamping DL, Ducruet T, Arsenault L, et al. VETO Study investigators. VEINES-QOL/Sym questionnaire was a reliable and valid disease-specific quality of life measure for deep venous thrombosis. J Clin Epidemiol. 2006; 59(10): 1049-56. doi: 10.1016/j.jclinepi.2005.10.016.
12. Kahn SR, Hirsch A, Shrier I. Effect of postthrombotic syndrome on health-related quality of life after deep venous thrombosis. Arch Intern Med. 2002; 162(10): 1144-8. doi: 10.1001/archinte.162.10.1144.
13. Broholm R, Sillesen H, Damsgaard MT, et al. Postthrombotic syndrome and quality of life in patients with iliofemoral venous thrombosis treated with catheter-directed thrombolysis. J Vasc Surg. 2011; 54(6S): 18-25. doi: 10.1016/j.jvs.2011.06.021.
14. Yildiz CE, Deser SB, Rodoplu O, Kaya A. The ımpact of radiofrequency ablation on quality of life/symptoms (VEINES-QOL/Sym questionnaire score) in patients with chronic venous ınsufficiency. Indian J Thorac Cardiovasc Surg. 2024; 40(2): 171-176. doi: 10.1007/s12055-023-01625-1.
15. Albernaz LF, Albernaz DTS, Zignani FR, et al. A comparison of tablet-based and paper-based venous insufficiency epidemiologic and economic study quality of life/symptom questionnaire for assessment of chronic venous disease. Phlebology. 2024; 39(1): 37-43. doi: 10.1177/02683555231208511.
16. Yildiz ÇŞ, Özlü ZK. Examınatıon of self-care agency and quality of life in individuals with chronic venous disease. J Vasc Nurs. 2021; 39(4): 114-119. doi: 10.1016/j.jvn.2021.08.001.
17. Ribeiro-Samora GA, Carvalho MLV, de Moura RMF, Pereira DAG. Limitations of VEINES QOL/SYM for discriminating chronic venous insufficiency severity. J Vasc Bras. 2019; 29: 19-20. doi: 10.1590/1677-5449.180096.
18. van der Velden SK, Biemans AA, Nijsten T, Sommer A. Translation and validation of the Dutch VEINES-QOL/Sym in varicose vein patients. Phlebology. 2014; 29(4): 227-35. doi: 10.1177/0268355513476279.
19. Kahn SR, M’lan CE, Lamping DL, Kurz X, Bérard A, Abenhaim LA; VEINES Study Group. Relationship between clinical classification of chronic venous disease and patient-reported quality of life: results from an international cohort study. J Vasc Surg. 2004; 39(4): 823-8. doi: 10.1016/j.jvs.2003. 12.007.
20. Ortega-Santana F, Limiñana JM, Ruano F, Ortega-Centol A, Palomino-Martín A, Jiménez F. The influence of the CIVIQ dimensions on quality of life of patients with primary superficial venous incompetence. Eur J Vasc Endovasc Surg. 2014; 48(4): 452-8. doi: 10.1016/j.ejvs.2014.07.006.
