Tags

Type your tag names separated by a space and hit enter

High prevalence of chronic venous disease among health care workers in the United States.
J Vasc Surg Venous Lymphat Disord. 2020 03; 8(2):224-230.JV

Abstract

BACKGROUND

Health care workers spend extended times standing and walking short distances and are at risk for development of chronic venous insufficiency (CVI). We conducted a hospital-wide venous screening program designed to measure the prevalence of and risk factors for clinical manifestations of CVI and ultrasound evidence of venous reflux or obstruction in health care workers. We also determined their risk for deep venous thrombosis (DVT).

METHODS

Free venous screening and education were offered to all hospital employees; the program started in April 2016, and results are presented from the first year. Demographics, medical history, and use of compression stockings were recorded. A physical examination determined the clinical class of the Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification for clinical disease, and an ultrasound test evaluated for reflux or obstruction in the common femoral vein, popliteal vein, and saphenofemoral junction. The Caprini score was recorded to evaluate risk of DVT. Descriptive statistics were reported, and logistic regression was used for multivariate analysis of risk factors.

RESULTS

We enrolled 636 participants (1272 legs); 93.0% were women. The median age was 42 years (interquartile range, 31-52 years), mean body mass index was 29.2 ± 6.6 kg/m2, and most participants were white (49.1%) or African American (39.5%); 18% reported having hypertension, 7.1% had diabetes, and 6.1% were current smokers. The majority reported occasional leg pain (72.7%) and evening leg swelling (42.3%). Only 2.7% used daily compression stockings. Clinical evidence of CVI was present in at least one leg in 69.1% (C1, 49.0%; C2, 17.7%; C3, 1.9%; C4, 0.2%; C5, 0.2%). Venous reflux was present in at least one leg in 82.1%; obstruction was rare (0.2%). Reflux in either the superficial (saphenofemoral junction) or the deep (femoral or popliteal) venous system was present in the majority (71.0%) of patients with CVI (clinical class ≥C1). Reflux and white race were risk factors for clinical disease; clinical disease, age, female sex, and white race were risk factors for reflux. On the basis of the Caprini score, 14.1% of participants were in the highest risk category for DVT when experiencing a high-risk situation (including 2.2% with history of DVT).

CONCLUSIONS

Prevalence of clinical CVI and venous reflux is high among health care workers despite a low frequency of cardiovascular comorbidities. Increased awareness about CVI and DVT and preventive strategies for venous disease must be instituted in this high-risk cohort.

Authors+Show Affiliations

Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, Md; Vascular Service, Veterans Affairs Medical Center, Baltimore, Md.Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, Md.Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, Md.Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, Md.Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, Md.Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, Md.Baltimore VA Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Baltimore, Md.Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, Md.Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, Md.Baltimore VA Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Baltimore, Md; Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland, Baltimore, Md.Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, Md; Vascular Service, Veterans Affairs Medical Center, Baltimore, Md; Baltimore VA Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Baltimore, Md. Electronic address: blal@som.umaryland.edu.

Pub Type(s)

Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

32067727

Citation

Cires-Drouet, Rafael S., et al. "High Prevalence of Chronic Venous Disease Among Health Care Workers in the United States." Journal of Vascular Surgery. Venous and Lymphatic Disorders, vol. 8, no. 2, 2020, pp. 224-230.
Cires-Drouet RS, Fangyang L, Rosenberger S, et al. High prevalence of chronic venous disease among health care workers in the United States. J Vasc Surg Venous Lymphat Disord. 2020;8(2):224-230.
Cires-Drouet, R. S., Fangyang, L., Rosenberger, S., Startzel, M., Kidwell, M., Yokemick, J., McDonald, T., Carlin, M., Sharma, J., Sorkin, J. D., & Lal, B. K. (2020). High prevalence of chronic venous disease among health care workers in the United States. Journal of Vascular Surgery. Venous and Lymphatic Disorders, 8(2), 224-230. https://doi.org/10.1016/j.jvsv.2019.10.017
Cires-Drouet RS, et al. High Prevalence of Chronic Venous Disease Among Health Care Workers in the United States. J Vasc Surg Venous Lymphat Disord. 2020;8(2):224-230. PubMed PMID: 32067727.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High prevalence of chronic venous disease among health care workers in the United States. AU - Cires-Drouet,Rafael S, AU - Fangyang,Liu, AU - Rosenberger,Sarah, AU - Startzel,Matthew, AU - Kidwell,Margaret, AU - Yokemick,John, AU - McDonald,Tara, AU - Carlin,Minerva, AU - Sharma,Jashank, AU - Sorkin,John D, AU - Lal,Brajesh K, PY - 2019/05/21/received PY - 2019/10/13/accepted PY - 2020/2/19/entrez PY - 2020/2/19/pubmed PY - 2020/9/15/medline KW - Chronic venous insufficiency KW - Deep venous thrombosis KW - Health care workers KW - Varicose veins KW - Venous reflux SP - 224 EP - 230 JF - Journal of vascular surgery. Venous and lymphatic disorders JO - J Vasc Surg Venous Lymphat Disord VL - 8 IS - 2 N2 - BACKGROUND: Health care workers spend extended times standing and walking short distances and are at risk for development of chronic venous insufficiency (CVI). We conducted a hospital-wide venous screening program designed to measure the prevalence of and risk factors for clinical manifestations of CVI and ultrasound evidence of venous reflux or obstruction in health care workers. We also determined their risk for deep venous thrombosis (DVT). METHODS: Free venous screening and education were offered to all hospital employees; the program started in April 2016, and results are presented from the first year. Demographics, medical history, and use of compression stockings were recorded. A physical examination determined the clinical class of the Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification for clinical disease, and an ultrasound test evaluated for reflux or obstruction in the common femoral vein, popliteal vein, and saphenofemoral junction. The Caprini score was recorded to evaluate risk of DVT. Descriptive statistics were reported, and logistic regression was used for multivariate analysis of risk factors. RESULTS: We enrolled 636 participants (1272 legs); 93.0% were women. The median age was 42 years (interquartile range, 31-52 years), mean body mass index was 29.2 ± 6.6 kg/m2, and most participants were white (49.1%) or African American (39.5%); 18% reported having hypertension, 7.1% had diabetes, and 6.1% were current smokers. The majority reported occasional leg pain (72.7%) and evening leg swelling (42.3%). Only 2.7% used daily compression stockings. Clinical evidence of CVI was present in at least one leg in 69.1% (C1, 49.0%; C2, 17.7%; C3, 1.9%; C4, 0.2%; C5, 0.2%). Venous reflux was present in at least one leg in 82.1%; obstruction was rare (0.2%). Reflux in either the superficial (saphenofemoral junction) or the deep (femoral or popliteal) venous system was present in the majority (71.0%) of patients with CVI (clinical class ≥C1). Reflux and white race were risk factors for clinical disease; clinical disease, age, female sex, and white race were risk factors for reflux. On the basis of the Caprini score, 14.1% of participants were in the highest risk category for DVT when experiencing a high-risk situation (including 2.2% with history of DVT). CONCLUSIONS: Prevalence of clinical CVI and venous reflux is high among health care workers despite a low frequency of cardiovascular comorbidities. Increased awareness about CVI and DVT and preventive strategies for venous disease must be instituted in this high-risk cohort. SN - 2213-3348 UR - https://www.unboundmedicine.com/medline/citation/32067727/High_prevalence_of_chronic_venous_disease_among_health_care_workers_in_the_United_States_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-333X(19)30594-3 DB - PRIME DP - Unbound Medicine ER -