scholarly journals O042 Impact of supine REM AHI on diagnostic sleep studies for OSA

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A19-A19
Author(s):  
J Callum ◽  
L Stranks ◽  
K Melehan ◽  
B Yee
Keyword(s):  
Supine Position ◽  
Subgroup Analysis ◽  
Average Duration ◽  
Additive Effect ◽  
Sleep Studies ◽  
Respiratory Events ◽  
Significant Difference ◽  
Supine Sleep ◽  
Chi Squared ◽  
The Impact

Abstract Introduction A conventional belief is that REM exacerbates positional OSA (POSA). Subsequently, PSGs often report on presence of supine REM with the presumption that without supine REM, the AHI may be underestimated. This study explores the impact of REM upon obstructive respiratory events in sleep when supine. Methods From 1/1/2019 through 31/12/2020 PSGs for OSA diagnosis performed using Sleepware G3 were reviewed. A subgroup analysis was conducted within POSA patients defined as 1) total AHI>10/hour and non-supine AHI<10/hr, 2) supine AHI>2x non-supine AHI and 3) at least 15min of supine and non-supine sleep. Data was analysed with Pearson’s Chi Squared Test using Stata 16.1. Results Supine REM occurred in 97% of the 467 PSG’s. The supine REM AHI was 32.1(95%CI 29.1–35.2), compared to supine NREM AHI of 36.6(33.5–39.6), non-supine REM AHI of 21.3(18.8–23.9) and non-supine NREM AHI of 19.9(17.3–22.5). Among 109 POSA patients the supine REM AHI was 31.7(26.1–37.4) compared to 28.9(24.8–32.9) in supine NREM, 9.5(6.1–12.9) in non-supine REM and 3.5(3.0–4.0) in non-supine NREM. The average duration of obstructive respiratory events was 27.3 seconds (26.2–28.5) in REM compared to 23.5 seconds (22.8–24.2) in NREM. This statistically significant difference did not persist in POSA patients. Discussion The results do not support an additive effect of REM beyond supine positioning among patients with POSA, however there is evidence that REM lengthens respiratory events, which may reduce AHI. In the POSA subgroup analysis, there was an increased AHI in REM compared to NREM only in the non-supine position.

Outcomes of Flank-Free Modified Supine Percutaneous Nephrolithotomy Based on BMI

2020 ◽  
pp. 1-6
Author(s):  
Esam Desoky ◽  
Khaled M. Abd Elwahab ◽  
Islam M. El-Babouly ◽  
Mohammed M. Seleem
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Supine Position ◽  
Normal Weight ◽  
Significant Difference ◽  
Group A ◽  
Morbid Obese ◽  
Group B ◽  
A Prospective Study ◽  
Nonobese Patients ◽  
The Impact

<b><i>Objective:</i></b> To evaluate the impact of body mass index (BMI) on the outcomes of percutaneous nephrolithotomy (PCNL) in the flank-free modified supine position. <b><i>Patients and Methods:</i></b> A prospective study was carried out in the urology department during the period from May 2015 to October 2019 on 464 patients admitted for PCNL. The patients were divided into 4 matched groups according to their BMI: group A, normal weight with 18.5 ≤ BMI &#x3c;25 kg/m<sup>2</sup>; group B, overweight with 25 ≤ BMI &#x3c;30 kg/m<sup>2</sup>; group C, obese with 30 ≤ BMI &#x3c;40 kg/m<sup>2</sup>; and group D, morbid obesity with BMI ≥40 kg/m<sup>2</sup>. All operative data as well as postoperative outcomes are recorded and compared to each other. <b><i>Results:</i></b> The 4 studied groups were matched regarding age. The comorbidities were slightly higher in groups C and D. The operative time and fluoroscopy time were slightly high in obese and morbid obese groups but with no significant difference. The rate of complications either major or minor was comparable in all groups. No significant difference was seen among all groups regarding hemoglobin loss, stone-free rate, hospital stay, and need for auxiliary procedures. <b><i>Conclusions:</i></b> The outcome of PCNL in flank-free modified supine position is not affected by changes in BMI. The procedure can be performed in obese and morbid obese patients safely with results similar to and comparable to nonobese patients.

To compare the impact of sitting and supine position on behavioral distress during immunization among children (1-3 years) in selected immunization clinics

2021 ◽  
pp. 351-358
Author(s):  
Grace Kurian ◽  
Theresa Leonilda Mendonca
Keyword(s):  
Supine Position ◽  
Control Group ◽  
Sitting Position ◽  
Immunization Group ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
And Control ◽  
The Impact ◽  
Experimental Group

Background of the study: Immunizations cause distress in children due to its acute pain. Younger children are particularly in need of intervention because they report more pain and display more behavioral distress during painful procedures. One of the effective non-pharmacological interventions of acute management is comfort position given by the parent. Comfort position provided by the parent during immunizations has been demonstrated to be useful in infants, toddlers and pre-school children. Yet, this simple intervention is not used on a routine basis. Aim: The aim of the study was to compare the impact of sitting and supine position on behavioral distress during immunization among children (1-3 years) in selected immunization clinics. Objectives of the study: To determine the impact of sitting position on behavioral distress of children receiving immunization (Group I - experimental group). 1. To determine the impact of supine position on behavioral distress of children receiving immunization (Group II - control group). 2. To compare the impact of sitting and supine position on behavioral distress of children during immunization. Methods: The research design adopted for the study was post test only control group design. Immunization clinic selected based on the convenience of the investigator. Purposive sampling technique used to select the sample and the sample were assigned randomly in to Group I(experimental group) and Group II(control group).To assess the impact of position: PBRS-R was used to assess the behavioral distress of children during immunization injection. Results: The collected data was analyzed by descriptive and inferential statistics. 1. Assessment of behavioral distress scores during immunization injection showed significant difference in mean scores in Group I (16.4±2.30) and in Group II (28.45±2.59). 2. Comparison of behavioral distress scores in Group I and Group II showed that there is a significant difference (p<0.05) in behavioral distress between experimental (Group I) and control (Group II) group. 3. Item wise comparison of behavioral distress scores in Group I and Group II showed that there is no significant difference(p<0.05) in behavioral distress between experimental (Group I) and control (Group II) group. Interpretation and conclusion: Findings of the study revealed that the comfort position, i.e., sitting position was effective in reducing behavioral distress during immunisation. Hence, paediatric nurses ought to promote the use of comfort position to reduce behavioral distress associated with painful procedure.

The Impact of Extramural Venous Invasion in Colorectal Cancer: A Detailed Analysis Based on Tumor Location and Evaluation Methods

2019 ◽  
Vol 28 (2) ◽  
pp. 120-127
Author(s):  
Young-Min Shin ◽  
Jung-Soo Pyo ◽  
Mee Ja Park
Keyword(s):  
Colorectal Cancer ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Survival Rates ◽  
Venous Invasion ◽  
Tumor Location ◽  
Evaluation Methods ◽  
Hazard Ratio ◽  
Significant Difference ◽  
The Impact

This study aimed to elucidate the prognostic implications of extramural venous invasion (EMVI) in colorectal cancer (CRC) through a meta-analysis. Eighteen eligible studies were included in this meta-analysis. Data on the prevalence of EMVI and the correlation between EMVI and survival were collected from these studies. In addition, a subgroup analysis was conducted based on tumor location and evaluation methods. The estimated prevalence of EMVI was 28.3% (95% confidence interval [CI] = 23.1% to 34.0%) in patients with CRC. The estimated prevalence of EMVI in patients with colon cancer and rectal cancer was 23.0% (95% CI = 17.6% to 29.6%) and 35.7% (95% CI = 22.3% to 51.6%), respectively. Based on the evaluation method, the estimated prevalence of EMVI were 28.3% (95% CI = 23.2% to 34.1%) and 27.3% (95% CI = 8.4% to 60.6%) in pathologic and radiologic examinations, respectively. The correlation of EMVI with worse overall and disease-free survival rates was significant (hazard ratio = 1.773, 95% CI = 1.483-2.120, and hazard ratio = 2.059, 95% CI = 1.683-2.520, respectively). However, in the subgroup analysis with radiologic examination, there was no significant difference in survival rates between patients with and without EMVI. Our study showed that EMVI was frequently detected in 28.3% of patients with CRC and was correlated to worse survival. The detection of EMVI can be useful for predicting the prognosis of patients with CRC.

scholarly journals P123: Retrospective review of transfusions for anemia ordered in the emergency department and concordance with guidelines

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S108
Author(s):  
Z. Siddiqi ◽  
E. Lang ◽  
D. Grigat ◽  
S. Vatanpour
Keyword(s):  
Emergency Department ◽  
Cost Effective ◽  
Deficiency Anemia ◽  
Time Period ◽  
Cost Effective Approach ◽  
Significant Difference ◽  
Blood Banks ◽  
Chi Squared ◽  
Red Blood Cell Transfusions ◽  
The Impact

Introduction: Iron Deficiency Anemia (IDA) is a common presentation to the emergency department (ED) and is often treated with red blood cell transfusions. Choosing Wisely and the American Association of Blood Banks released guidelines in 2016 outlining under what circumstances transfusions should be given for patients with IDA. Few well-powered studies have looked at the impact of these guidelines on transfusions in EDs. The goal of this study was to examine the number of RBC transfusions that were given in EDs in Calgary, Alberta from 2014-2018 and what proportion of these were potentially avoidable (PA). Methods: We analyzed 8651 IDA patient encounters from 2014–2018 at four centers in the Calgary Zone. A transfusion was considered PA if the patient's hemoglobin (hgb) was ≥70 g/L AND if the patient was hemodynamically stable. We performed descriptive statistics to assess the number of transfusions and the number of avoidable transfusions. We used chi-squared tests to determine if there were significant differences between site, time-period, hemoglobin level. Results: In total, 990 (11.4%) of the encounters received transfusions; 711 (71.8%) were indicated while 279 (28.1%) were PA. Out of the transfusions that were indicated, 230 (32.3%) were given to patients with a hgb &lt;70 g/L and 481 (67.7%) were given to patients with a hgb &gt;70 g/L but who were hemodynamically unstable. Out of the transfusions that were PA, the highest number were given to those in the 71-80 g/L hgb group (142) and the lowest number were given to those in the 110-130 g/L hgb group (9), a difference that was statistically significant (p &lt; 0.001). The PA transfusion rates from 2014 to 2018 were 30.8%, 25.6%, 34.5%, 23.6%, 20.7% respectively, which was a statistically significant difference (p = 0.004). Conclusion: Our data suggest that the number of PA transfusions at the hospitals in the Calgary zone is comparable to the rates reported in the existing literature. In addition, the rate of PA transfusions has decreased since the release of the guidelines. A limitation of the present study was that it did not look at the number of units of red blood cells transfused and since many patients receive more than one unit, it is possible that the number of PA transfusions was underestimated. Nevertheless, we intend to use our results to create a safer and more cost-effective approach to managing IDA.

scholarly journals The effect of nerve-sparing surgery on patient-reported continence post-radical prostatectomy

2013 ◽  
Vol 3 (6) ◽  
pp. 465 ◽  
Author(s):  
Paul Toren ◽  
Shabbir M.H. Alibhai ◽  
Andre Matthew ◽  
Michael Nesbitt ◽  
Robin Kalnin ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Health Utility ◽  
Urinary Continence ◽  
Nerve Sparing ◽  
Urinary Frequency ◽  
Significant Difference ◽  
Patient Reported ◽  
Chi Squared ◽  
Dysfonction Sexuelle ◽  
The Impact

Introduction: Urinary continence significantly affects quality of lifeafter radical prostatectomy (RP). The impact of nerve-sparing surgeryon continence is unclear from the current literature.Methods:We identified men with prostate cancer from the UniversityHealth Network Prostate Centre database who underwent RP.Preoperatively and at each postoperative visit, patients completedthe Patient-Oriented Prostate Utility Scale (PORPUS), a validatedpsychometric and health utility instrument. Incontinence was definedby a single questionnaire item. Patients with radiotherapy or lessthan 10 months follow-up were excluded. Chi-squared tests andANOVA were used to compare groups. Multivariable logisticregression was used to control for effects of nerve-sparing andother covariates.Results: Of the 253 eligible patients from 2003 to 2007, 159 patientshad bilateral nerve-sparing, 32 had unilateral nerve-sparing and62 had non-nerve-sparing surgery. Of these patients, 27%, 17%and 34%, respectively, were classified as incontinent at 1 year.These proportions were not significantly different between groups(p = 0.23). Multivariable logistic regression showed baseline urinarycontinence and urinary frequency to be significant predictorsof patient-reported continence at 1 year postoperatively, withodds ratios of 1.7 (95% confidence interval [CI] 1.1-2.9) and 1.5(95% CI 1.0-2.3), respectively.There was a significant difference in the proportion of PORPUSsexual function scores between nerve-sparing groups after excludingthose with baseline sexual dysfunction (p = 0.003). Similarly,health-related utility scores were different across groups (p < 0.001).Conclusion: Our results do not suggest a difference in 1-year patientreportedcontinence based on the type of nerve-sparing RP.However, baseline continence and urinary frequency were significantpredictors of continence at 1 year.Introduction : L’incontinence urinaire réduit grandement la qualitéde vie après une prostatectomie radicale (PR). Or, les donnéespubliées ne permettent pas d’établir l’impact sur la continenced’une intervention avec préservation des filets nerveux.Méthodologie : Des hommes atteints de cancer de la prostate etayant subi une PR ont été trouvés dans la base de données duUniversity Health Network Prostate Centre. Avant l’interventionet lors de chaque visite après celle-ci, les patients devaient utili -ser le questionnaire PORPUS d’auto-évaluation, un instrumentvalidé de psychométrie sur les troubles de la prostate et l’état desanté. Un seul point du questionnaire a trait à l’incontinence. Lespatients ayant reçu une radiothérapie ou dont le suivi était inférieurà 10 mois étaient exclus. Les groupes ont été comparés à l’aidede tests du chi carré et d’analyses ANOVA. Une analyse de régressionlogistique multivariée a permis de vérifier les effets de lapréservation des filets nerveux et d’autres covariables.Résultats : Sur les 253 patients admissibles traités entre 2003 et2007, 159 avaient subi une intervention bilatérale avec préservationdes filets nerveux, 32, une intervention unilatérale avec préservationdes filets nerveux et 62, une intervention sans préservationdes filets nerveux. De ces nombres, 27 %, 17 % et 34 %respectivement étaient considérés incontinents après un an. Laproportion de patients incontinents n’était pas significativementdifférente entre les groupes (p = 0,23). L’analyse de régressionlogistique multivariée a fait ressortir que la continence urinaire etla fréquence mictionnelle au départ étaient des facteurs de prédictionimportants de la continence évaluée par les patients unan après l’intervention, les rapports des risques étant respectivementde 1,7 (intervalle de confiance [IC] à 95 % : 1,1 à 2,9) et1,5 (IC à 95 % : 1,0 à 2,3).Une différence significative a été notée dans le taux de scoresPORPUS de dysfonction sexuelle entre les groupes ayant subi uneintervention avec préservation des filets nerveux, après exclusiondes patients présentant une dysfonction sexuelle au départ (p =0,003). De même, les scores concernant l’état de santé étaientdifférents d’un groupe à l’autre (p < 0,001).Conclusion : Nos résultats ne portent pas à croire à l’existence d’unedifférence sur le plan de la continence un an après l’interventionen fonction du type de PR avec préservation des filets nerveux.Cependant, la continence et la fréquence mictionnelle au départconstituent d’importants facteurs de prédiction de la continenceun an après l’intervention.

scholarly journals Emergency Department Crowding is Harder to Solve: The Impact of COVID-19 of Longer Length of Stay

2021 ◽  
Author(s):  
Fengbao Guo ◽  
Yan Qin ◽  
Hailong Fu ◽  
Feng Xu
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Emergency Department Crowding ◽  
Wilcoxon Rank Sum Test ◽  
Significant Difference ◽  
Chi Squared ◽  
The Difference ◽  
Emergency Neurology ◽  
The Impact ◽  
Case Data

Abstract Objectives To determine the impact of the Coronavirus disease-2019 (COVID-19) pandemic on the length of stay (LOS) and prognosis of patients in the emergency department (ED). Methods A retrospective review of case data of patients in the ED during the early stages of the COVID-19 pandemic in the First Affiliated Hospital of Soochow University (January 15, 2020– January 14, 2021) was performed and compared with that during the pre-COVID-19 period (January 15, 2019 – January 14, 2020). Patient information including age, sex, length of stay, and death was collected. Wilcoxon Rank sum test was utilized to compare the difference in LOS between the two cohorts. Chi-Squared test was utilized to analyze the prognosis of patients. The LOS and prognosis in different departments (emergency internal medicine, emergency surgery, emergency neurology, and other departments) were further analyzed. Results Of the total 8278 patients, 4159 (50.24%) were ordered in the COVID-19 pandemic group and 4119 (49.76%) were ordered in the pre-COVID-19 group. The length of stay prolongs significantly in the COVID-19 group compared with that in the pre-COVID-19 group(13h vs 9.8h; p < 0.001). There was no significant difference in mortality between the two cohorts (4.8% VS 5.3%; p=0.341). Conclusion The COVID-19 pandemic was associated with a significant increase in the length of stay, which may lead to emergency department crowding. And the influence of the COVID-19 pandemic on patients in different emergency departments is different. There is no significant impact on the LOS of emergency neuropathy. Across departments, COVID-19 didn’t have a significant impact on the prognosis of ED patients.

scholarly journals The Effects of Cigarette Smoking on Steroidal Muscular Relaxants and Antibiotics Used: A Prospective Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Na Liu ◽  
Feng Wang ◽  
Qian Zhou ◽  
Minhuan Shen ◽  
Jing Shi ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
General Anesthesia ◽  
Onset Time ◽  
Time Duration ◽  
Recovery Index ◽  
Significant Difference ◽  
Chi Squared ◽  
History Of ◽  
The Impact

Background: The impact of cigarette smoking on perianesthesia management is not clear elucidated. This paper studies the impact of long-term cigarette smoking on the dose-response of rocuronium and vecuronium used under general anesthesia and the type of antibiotics used after surgery.Methods: We enrolled 240 participants from a teaching hospital in China in which finally enrolled in 221 participants. 106 participants have a history of long-term cigarette use and 115 participants without a history of smoking. All participants received general anesthesia for various surgeries, and rocuronium was used as the muscular relaxant. The primary outcome was the effective onset time of rocuronium after adjusting for its dose. The secondary outcomes included a recovery index and the time of muscle recovery changing from 25 to 75%.Results: There was no measurable difference in the muscle relaxant onset time, duration of effectiveness, 75% recovery, recovery index, dose of opiates, anesthetics during surgery, or complication rate between smokers or non-smokers. However, the results showed a significant difference in antibiotic use between smokers and non-smokers (chi-squared = 13.695, p &lt; 0.001), and a significant difference in the type of antibiotics used (chi-squared = 21.465, p = 0.003). Smokers had a significantly higher rate of cefathiamidine use.Conclusion: Smoking cigarettes had no effect on muscle relaxants used under general anesthesia, but patients who had a history of smoking were more likely to receive antibiotics after surgery.Clinical Trial Registration:http://www.chictr.org.cn/index.aspx, identifier ChiCTR-OIC-16009157.

scholarly journals Do Body Mass Index Levels Correlate with Tinnitus Among Teachers?

2021 ◽  
Author(s):  
Luciana Lozza de Moraes Marchiori ◽  
Glória de Moraes Marchiori ◽  
Priscila Carlos ◽  
Samuel Lopes Benites ◽  
Marina Stephany Bobroff Mendes ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Cross Sectional Study ◽  
Age Group ◽  
Moderate Correlation ◽  
Cross Sectional ◽  
Significance Level ◽  
Significant Difference ◽  
Chi Squared ◽  
The Impact

Abstract Introduction Working conditions can contribute to the development of lifestyle-related diseases among teachers, including obesity and tinnitus. Describing tinnitus in relation to characteristics and comorbidities can help the treatment and prognosis of teachers affected by this symptom. Objective To verify a possible association between tinnitus complaint and body mass index (BMI) in teachers. Methods Cross-sectional study with a sample of teachers who responded to the Visual Analog Scale (VAS) and to the Tinnitus Handicap Inventory (THI). The BMI (kg/m2) was calculated based on self-reported body weight (in kilograms) divided by height (in meters squared). Nonparametric statistics were applied adopting a significance level < 0.05 Results A total of 83 teachers were assessed, with a mean age 48 ± 9.7 years old; 63.9% (n= 53) were females; 44.6% were eutrophic (n = 37), and 16.9% (n = 14) were obese. Of the total, 19.3% (n = 16) reported tinnitus. No differences were found between the groups and BMI (p > 0.05), although there was a significant difference between the Tinnitus and No Tinnitus groups for age (p < 0.001). The chi-squared test showed an association between age group and tinnitus (p < 0.028); those with tinnitus were in the 49 to 65 years old age group. In addition, there was a moderate correlation between tinnitus parameters (VAS; THI-Functional; THI-Total) and BMI. Conclusion There was a moderate correlation between tinnitus parameters and BMI indicating that, as the BMI increased, so did the impact of tinnitus in the lives of the teachers. Body mass index should be considered a factor in tinnitus assessment and rehabilitation process.

scholarly journals Impact on Diabetes Management of the Restrictions of Social Participation to Combat the COVID-19 Pandemic at a Single Facility in Japan: A Retrospective, Observational Study

2021 ◽  
Author(s):  
Toshiki Kogai ◽  
Kazutoshi Fujibayashi ◽  
Naotake Yanagisawa ◽  
Nobuyuki Fukui ◽  
Akihiko Takahashi ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Diabetes Management ◽  
Diabetic Patients ◽  
Improvement Rate ◽  
Deterioration Rate ◽  
Significant Difference ◽  
Chi Squared ◽  
The Impact ◽  
Hba1c Levels

Abstract Background: The aim of this study was to clarify the impact of limitations of activity due to the COVID-19 pandemic on diabetes management.Methods: To clarify the impacts of the emergency declared on April 7 2020, 345 patients, 1109 patients, and 752 patients whose HbA1c levels were measured in both March and April, May, or June were selected. The patients to be compared were selected from the 2019 data under the same conditions. In 2019, 469 patients, 1315 patients, and 783 patients whose HbA1c levels were measured in both March and April, May, or June were selected. The impact of restricted activity on diabetes management due to the declared emergencies was assessed by comparing HbA1c levels in April, May, and June minus the HbA1c levels in March of both 2019 and 2020. Subjects with a difference in HbA1c levels greater than 0 were defined as “worsened”, and subjects with a difference in HbA1c levels less than or equal to 0 were defined as “improved”. The deterioration rate and the improvement rate of the HbA1c level in 2019 and 2020 were compared by the Chi-squared test. Second, the linear trends of HbA1c from April to June between 2019 and 2020 were calculated by mixed model repeated measures ANOVA.Results: There were more patients with worsening HbA1c levels from March to April in 2020 than in 2019: 122 (26.0%) vs. 137 (39.7%), p<0.01. There were more patients with improved HbA1c levels from March to June in 2020 than in 2019: 478 (61.0%) vs. 512 (68.1%), p<0.01. Patients with improved HbA1c levels between March and May showed no significant difference between 2020 and 2019: 814 (61.9%) vs. 713 (64.3%), p=0.23. Slopes of HbA1c levels from April to June in 2019 and 2020 were -0.0024 (-0.0039, -0.0009) and -0.0099 (-0.0117 -0.0081), respectively. There were significant differences in the slopes -0.0075 (-0.0097, -0.0053), p<0.01) between the years.Conclusions: HbA1c levels did not appear to show persistent deterioration during the observational period in 2020. Meanwhile, some diabetic patients may have shown both improved and worsened diabetes control during the COVID-19 pandemic.

Risk of venous thromboembolism following surgical treatment of superficial venous incompetence

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 484-489 ◽  
Author(s):  
Tom Barker ◽  
Felicity Evison ◽  
Ruth Benson ◽  
Alok Tiwari
Keyword(s):  
Venous Thromboembolism ◽  
Varicose Vein ◽  
Lower Incidence ◽  
Varicose Veins ◽  
Secondary Data ◽  
Foam Sclerotherapy ◽  
Increased Risk ◽  
Significant Difference ◽  
Chi Squared ◽  
One Year

Abstract. Background: The invasive management of varicose veins has a known risk of post-operative deep venous thrombosis and subsequent pulmonary embolism. The aim of this study was to evaluate absolute and relative risk of venous thromboembolism (VTE) following commonly used varicose vein procedures. Patients and methods: A retrospective analysis of secondary data using Hospital Episode Statistics database was performed for all varicose vein procedures performed between 2003 and 2013 and all readmissions for VTE in the same patients within 30 days, 90 days, and one year. Comparison of the incidence of VTEs between procedures was performed using a Pearson’s Chi-squared test. Results: In total, 261,169 varicose vein procedures were performed during the period studied. There were 686 VTEs recorded at 30 days (0.26 % incidence), 884 at 90 days (0.34 % incidence), and 1,246 at one year (0.48 % incidence). The VTE incidence for different procedures was between 0.15–0.35 % at 30 days, 0.26–0.50 % at 90 days, and 0.46–0.58 % at one year. At 30 days there was a significantly lower incidence of VTEs for foam sclerotherapy compared to other procedures (p = 0.01). There was no difference in VTE incidence between procedures at 90 days (p = 0.13) or one year (p = 0.16). Conclusions: Patients undergoing varicose vein procedures have a small but appreciable increased risk of VTE compared to the general population, with the effect persisting at one year. Foam sclerotherapy had a lower incidence of VTE compared to other procedures at 30 days, but this effect did not persist at 90 days or at one year. There was no other significant difference in the incidence of VTE between open, endovenous, and foam sclerotherapy treatments.

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