The influence of socioeconomic factors on intervention and postoperative healing of venous ulcers: a prospective study.

ABSTRACT

OBJECTIVE: In previous studies, venous ulcers (VUs) have been found to occur more often in patients with lower socioeconomic status. The aim of this study was to explore if socioeconomic factors influence the delay of referral to a vascular service or the time to healing after superficial venous intervention. METHOD: In this prospective study, patients answered a questionnaire about the duration and recurrence of their VU, comorbidities, body mass index (BMI), smoking, alcohol, social and physical activities, ambulatory status, education, marital status, housing, perceived economic status and dependence on home care. Postoperative complications, VU healing and recurrence were noted one year after superficial venous intervention. RESULTS: A total of 63 patients were included in this study (30 females and 33 males), with a mean age of 71.2 years (range 37-92 years). Duration of the present VU in patients was <3 months in 48%; 3-6 months in 27%; 6-12 months in 11%; and >12 months in 14%. Risk factors for delayed referral were recurrent VU (odds ratio (OR) 4.92; p=0.021); walking impairment (OR 5.43; p=0.009) and dependence on home care (OR 4.89 p=0.039) in a univariable analysis. The latter was the only significant finding in a multivariable analysis with socioeconomic risk factor (OR 4.89; p=0.035). In 85% of patients, their VU healed without recurrence during one year follow-up. Healing took longer if the patients were of older age (p=0.033); had a normal BMI (independent samples t-test, p=0.028); had a recurrent VU (OR 5.00; p=0.049); or walking impairment (Fishers exact test, OR 9.14; p=0.008), but no significant socioeconomic risk factors were found. CONCLUSION: In this study, socioeconomic factors were not important risk factors for delayed referral of VU patients to a vascular service or prolonged healing time after superficial venous intervention. DECLARATION OF INTEREST This work was supported by the Scandinavian Research Foundation for Varicose Veins and other Venous Diseases (SFÅV) and by ALF funding from Region Örebro County. The authors have no conflicts of interest to declare.