Lower limb varicose disease in men and women: findings of prospective study SPECTRUM

Kirienko A.I., Zolotukhin I.A., Yumin S.M., Seliverstov E.I.

Chair of Faculty Surgery of the Therapeutic Department of the Russian National Research Medical University named after N.I. Pirogov, Moscow, Russia

Objective. The study was aimed at comparing peculiarities of varicose disease, its complications, treatment policy in men and women.

Materials and methods. The prospective observational study SPECTRUM follows up a total of 866 patients with venous chronic disease. Of these, 615 were found to have varicose disease (VD) (486 (79.0%) women and 129 (21.9%) men). The patients’ age varied from 12 to 83 years old (mean age 46.1, median 46). The body weight index ranges from 15.7 to 62.0 (average 27.2, me¬dian 26.0). The duration of the disease from the moment of being included into the program ranges from 0.1 to 53 years (mean 14.5, median 11, interquartile range from 5 to 20).

Results and discussion. No differences by age, body mass index were observed. Men consulted the phebologist averagely at earlier stages of the disease onset (after 10.9 years as compared with 15.5 years for women; p=0.00001). The frequency of detecting subjec¬tive symptoms does not differ along the majority of the measures, with men less often reporting the development of pain syndrome (45.7% versus 65.2% for women; p=0.0001). The proportion of patients with class C4-C6 amongst men and women does not differ (29.5% and 24.1%, respectively; p=0.211). No differences in the incidence of varicosephlebitis, external bleeding from the venous node were revealed. Men were found to have more often total reflux along the great saphenous vein on the right leg (35.7% as compared with 25.1% for women; p=0.017) and insufficiency of perforants (72.9% versus 59.7%; p=0.006). Women were more often found to have isolated varicosity of inflows-confluents. 47.3% of men had not previously attended presented consulted for VD, amongst women the proportion of such cases was considerably lower (28.6%; p=0.000001). Only 6.0% of women had previously not undergone any treatment for VD. Amongst men the share of previously not treated amounts to 23.3% (p=0.000001).

Women were statistically significantly more often prescribed phleboscleroobliteration the inflows confluents. The recommendations of phlebologists on using compression, pharmacotherapy, surgical methods did not differ in men and women.

Conclusion. The obtained differences are not principal. The course of VD is similar in patients of different gender, which is confirmed by identity of treatment policy.

KEY WORDS: varicose disease, men, women, SPECTRUM study.

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