Clinical Impact of Severe Obesity in Patients with Lymphoedema.
Eur J Vasc Endovasc Surg
; 65(3): 406-413, 2023 03.
Article
en En
| MEDLINE
| ID: mdl-36403939
ABSTRACT
OBJECTIVE:
With the rate of obesity increasing worldwide, patients with lymphoedema with and without a concomitant diagnosis of severe obesity (SO) were compared in regard to their baseline demographics, health related characteristics, treatment plans, and patient outcomes.METHODS:
This was a retrospective observational cohort study. The IBM MarketScan database was examined (2013 - 2019) for patients with a new diagnosis of lymphoedema. Of 60 284 patients with lymphoedema identified, 6 588 had SO defined by a body mass index > 40 kg/m2. The demographics and other characteristics of SO were compared with patients with lymphoedema without SO.RESULTS:
SO and lymphoedema diagnosis increased two fold from 2013 to 2019. The lymphoedema SO+ group was younger (57.8 vs. 60.8 years, p < .001) and with a higher proportion of men (37.7% vs. 24.9%, p < .001) than the lymphoedema SO- group. More comorbidities were observed in the lymphoedema SO+ group than the lymphoedema SO- group diabetes 46.0% vs. 24.9 % (p < .001), heart failure 18.3% vs. 7.4% (p < .001), hypertension 75.0% vs. 47.6% (p < .001), and renal disease 24.8% vs. 11.9% (p < .001). Use of diuretics in the lymphoedema SO+ group was greater 57.6% vs. 38.0% (p < .001). Patients with lymphoedema SO+ had higher risk of cellulitis 34.5% vs. 13.5% (p < .001). Specific lymphoedema treatment was given more often to lymphoedema SO- 66.3% vs. 64.3% (p = .003). This was significant for manual lymphatic drainage (46.6% vs. 40.0%; p < .001) and physical therapy (55.4% vs. 51.6%; p<.001), but not for compression garments (18.2% vs. 17.7%; p = .38). However, more patients with lymphoedema SO+ received pneumatic compression device treatment 20.9% vs. 13.7% (p < .001).CONCLUSION:
There was an increase in SO associated lymphoedema. Patients with lymphoedema SO+ have over a two and half fold increase in cellulitis incidence, with a significant increase in medical resource use and cost. Despite this, patients with lymphoedema and SO receive less specific therapy such as compression, which has proven to reduce cellulitis incidence.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Obesidad Mórbida
/
Linfedema
Tipo de estudio:
Guideline
/
Prognostic_studies
Límite:
Humans
/
Male
Idioma:
En
Revista:
Eur J Vasc Endovasc Surg
Asunto de la revista:
ANGIOLOGIA
Año:
2023
Tipo del documento:
Article