title: Construction and evaluation of a multidimensional score to assess varicose vein severity - the Homburg Varicose Vein Severity Score (HVVSS).
abstract: To evaluate a novel score (HVVSS) for varicose vein patients combining subjective symptoms, clinical findings and functional data of venous insufficiency. 91 patients (118 legs) with primary varicose veins of the great, small or accessory anterior saphenous vein were treated with conventional surgery. HVVSS was assessed pre- and 3 months postoperatively. The data were compared with established clinical and disease-related life quality scores (VCSS, AVVQ, CIVIQ). Test responsiveness, validity and reliability were determined using correlations with CEAP stage and venous refilling time as hemodynamic parameter, and inter-observer variability was assessed. All scores were highly responsive to varicose vein surgery (p<0.001). HVVSS(0-100) decreased from 34.1 ± 13.0 to 9.6 ± 6.9 postoperatively. The relative score change of HVVSS was superior to VCSS (69.5% vs. 58.8%, p=0.005). HVVSS revealed highly significant correlations with the clinical CEAP stage and was exclusively able to differentiate mild from severe disease as defined by venous refilling time (p=0.009). Inter-observer reliability of HVVSS was confirmed by correlation coefficients of 0.977 and 0.950 pre- and postoperatively (p<0.001). HVVSS is a suitable and reliable tool to assess disease severity in varicose vein patients and to quantify therapeutic effects of varicose vein treatment.
authors.affiliation: Department of Dermatology, Venerology and Allergology, Saarland University Hospital, 66421 Homburg, Germany. knuth.rass@uks.eu
authors.forename: Knuth
authors.initials: K
authors.lastname: Rass
authors.forename: Mönchzezeg
authors.initials: M
authors.lastname: Daschzeren
authors.forename: Stefan
authors.initials: S
authors.lastname: Gräber
authors.forename: Thomas
authors.initials: T
authors.lastname: Vogt
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Tilgen
authors.forename: Norbert
authors.initials: N
authors.lastname: Frings
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014648:Varicose Veins / Q000473:pathology* / Q000601:surgery*