title: Generic health-related quality of life is significantly worse in varicose vein patients with lower limb symptoms independent of CEAP clinical grade.
abstract: OBJECTIVE
  To determine the relationship between lower limb symptoms and generic health-related quality of life (HRQL) in patients with varicose veins (VV).
  
  
  METHODS
  284 patients on the waiting list for VV treatment completed the Short Form-12 (SF12) and a questionnaire asking about the presence of lower limb symptoms commonly attributed to venous disease (pain or ache, itching, tingling, cramp, restless legs, a feeling of swelling, and heaviness).
  
  
  RESULTS
  Median age was 57 years (interquartile range 45-67); 100 (35%) were male, and 182 (64%) had CEAP clinical grade 2 or 3 disease. Jonckheere-Terpstra test for trend revealed that both physical (P < .0005) and mental (P = .001) HRQL worsened as the reported number of symptoms increased. Patients reporting tingling (P = .016, Mann-Whitney U test), cramp (P = .001), restless legs (P < .0005), swelling (P < .0005), and heaviness (P < .0005) had a significantly worse physical HRQL than those who did not. Mental HRQL was also significantly worse in patients with tingling (P = .010), cramp (P = .008), restless legs (P = .040), swelling (P = .001), and heaviness (P = .035). These significant relationships remained, and pain was also correlated with worse physical HRQL (P = .011), when linear regression was performed to control for CEAP clinical grade, age and sex.
  
  
  CONCLUSIONS
  Physical and mental HRQL is significantly worse in VV patients with lower limb symptoms irrespective of the clinical stage of disease. This observation confirms that VV are not primarily a cosmetic problem and that NHS rationing of treatment to those with CEAP C4-6 disease excludes many patients who would benefit from intervention in terms of HRQL. Generic HRQL instruments also allow comparison with interventions for other chronic conditions.
authors: Birmingham University, Department of Vascular Surgery, Heart of England NHS Trust, Birmingham, UK. katydarvall@btinternet.com
authors: K A L
authors: KA
authors: Darvall
authors: G R
authors: GR
authors: Bate
authors: D J
authors: DJ
authors: Adam
authors: A W
authors: AW
authors: Bradbury
mesh_terms: D000368:Aged; D002908:Chronic Disease; D017281:Cost of Illness; D004739:England; D005260:Female; D015276:Health Care Rationing; D006801:Humans; D016014:Linear Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013222:State Medicine; D011795:Surveys and Questionnaires; D014648:Varicose Veins / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy