Expectations versus reality in chronic venous ulceration; a quality of life assessment study

Abstract

Introduction: Chronic venous ulceration is a common problem worldwide with a significant effect on
Quality of Life (QoL).
Objectives: Our objective was to assess Sri Lankan patients’ perspective with regard to this scenario.
Methods: We involved 141 consenting patients presenting to the OPD, National Hospital with a venous
ulcer lasting one month or more. Data was collected using an interviewer administered questionnaire, a
clinical interview and a lower limb duplex scan. Short form 36 questionnaire was used for QoL
assessment.
Results: The majority were elderly (median age 53 years) men (n=9[69.5%]). Fifty four (38.3%) were
unemployed at the time of the study and 28 (19.9%) directly attributed the ulcer as the cause for
unemployment. Median duration of ulcer was 10[1-360] months and mean Venous Clinical Severity
Score (VCSS) was 13.85(4-24). Family history (44[31.2%]), previous limb trauma or non-venous
surgery (24[17.0%]), smoking among men (57 [58.2%]) and history of pregnancy among females
(34[79.1%]) were identified as risk factors. Role limitation due to physical health (28.4[SD 42.8]) and
role emotional problems (40.9 [SD 46.7]) had a mean SF 36 score below 50. Factors such as pain,
duration of ulcer, older age and higher BMI significantly affected many domains of QoL (p<0.05). Sixty
six (46.8%) patients continue to have ulcers despite having had surgical treatment for varicose veins.
Conclusions: Venous ulcers have a considerable impact on the quality of life in Sri Lankan patients
with venous ulcer. The need for providing preventive and rapid healing methods together with social
support must be emphasized.