clinical presentation and associated factors of lower limb chronic venous insufficiency at mulago national referral hospital, a cross-sectional study

Description

Introduction: Lower limb chronic venous insufficiency (CVI) is a common disorder associated with sequelae of changes that lead to varicose veins and skin trophic changes. Knowledge of its potential associated factors and clinical presentation is important in clinical practice because of the significant impact on the quality of life. Objective: This study sought to determine the clinical presentation and associated factors of lower limb chronic venous insufficiency among patients at Mulago National Referral Hospital (MNRH). Methods; We conducted a cross-sectional study of 104 consecutive participants with CVI aged ≥ 18 years attending the outpatient clinics of MNRH. Limbs of participants with history of surgery pertaining to CVI were excluded. We recorded information on demographics, relevant medical history, symptoms, lifestyle and clinical presentation. We described CVI using the clinical and anatomical components of the clinical-etiologic-anatomical and pathophysiologic (CEAP) scale. Data was analyzed at both bivariate and multivariate levels using Stata version 14.1 Results; altogether, 104 participants were enrolled, with a male: female ratio of 2:1 and age range of 18 to 85 years, median age of 43 years. The commonest venous symptoms included; venous pain (96.2%), sensation of swelling (93.3%) and heaviness (79.8%). Of the 146 affected limbs, CEAP clinical class included; C0:59.6%, C1:40.4%, C2:80.8%, C3:88.5%,C4:73.1%, C5:30.8%, C6:51.9%. The anatomical class identified superficial veins in 138 (90.5%), deep veins in 46 (29.7%) and perforator veins in 122 (79.7%) affected limbs. Men had significantly higher proportions (4.5 times higher odds) of skin trophic changes (p=0.003) while females had significantly higher proportions of venous symptoms (p=0.015). All participants with a smoking history had skin changes. Overweight patients had higher proportions for venous symptoms. Conclusion: The patients tend to be young and predominantly male. The morbidity is high because most patients are symptomatic with advanced disease. There was a clear association between smoking, body mass index and CVI.