Patient, operative, and surgeon factors that influence the effect of superficial venous surgery on disease-specific quality of life

Abstract

Background and objective: Superficial venous surgery for CEAP 2 disease leads to an improvement in disease-specific quality of life (QoL) in the short term. However, which factors influence the magnitude of this improvement, how surgery affects QoL in patients with CEAP 4 to 6 disease, and whether this improvement is durable are not known. The objective of this study was to identify patient, operative, and surgeon factors that might influence the change in disease-specific QoL in the 2 years after superficial venous surgery. Methods: This prospective study was comprised of 203 unselected, consecutive patients with CEAP 2 to 6 disease who underwent saphenous with or without subfascial endoscopic perforator surgery and who completed the Aberdeen Varicose Vein Symptoms Severity Score (AVVSSS) before surgery and at 4 weeks, 6 months, and 2 years after surgery. Univariate and multivariate analyses were performed. Results: At baseline, recurrent and ulcer (CEAP 5 and 6) diseases were associated with a higher (worse) AVVSSS. Surgery was associated with a significant improvement in median (interquartile range [IQR]) AVVSSS: baseline, 17.8 (11.8 to 27.2); 4 weeks, 13.8 (7.9 to 21.3); 6 months, 9.6 (4.2 to 15.8); and 2 years, 8.1 (4.0 to 14.7). One hundred seventy-five patients (86%) at 6 months and 177 patients (87%) at 2 years reported an improvement in AVVSSS. Postoperative AVVSSS at both 6 months and 2 years was most significantly influenced by preoperative score (P