Current state of manifestation, diagnosis and treatment of chronic venous disease in patients treated by specialists in the Czech Republic - results of a cross-sectional survey CVD control
Abstract
Background: Chronic Venous Disease (CVD) is a progressive inflammatory condition that affects over 50% of the population. Its late stages, especially leg ulcers, often lead to disability.
Therefore, early diagnosis and treatment of CVD is important, which can prevent progression to higher stages of the disease. Prerequisite for achieving adequate detection and treatment of this disease is knowledge of the real situation.
Aims of the project: The aim of the research was to obtain current information from real practice about the frequency of risk factors, the occurrence of signs and symptoms, the use of diagnostic methods and the therapy used in patients with CVD treated by specialists. Methods: A cross-sectional survey was conducted at 89 workplaces of angiologists, vascular surgeons and dermatologists in the Czech Republic in the first half of 2019.
It included adult patients with newly and previously diagnosed CVD. Using a questionnaire filled out by physicians, the incidence of risk factors, signs and symptoms of CVD, time to treatment, diagnostic tests performed, and treatment used were determined.
Results: 890 patients with a mean age of 61 years were included in the registry. The presence of 2-4 symptoms of CVD was found in 74% of patients and the presence of 2-3 risk factors for CVD in 65% of patients.
CVD treatment was often initiated many years after the onset of the first symptoms. Patients under 40 years of age delayed treatment in 52% of cases. 27% of patients had stage C5-C6, of which 19% had an open leg ulcer.
Sonographic examination was performed in only 68% of patients. Of the patients in higher stages (C5-C6), this examination was absent in 27%.
Compression therapy was used by 36% of patients regularly and 44% occasionally. 32% of patients had a history of surgical treatment of CVD, only 22% of patients in stage C5-C6. Venofarmaka was used by 85% of patients, but only 2/3 of them took it throughout the year.
Conclusion: This survey showed that patients and physicians still underestimate CVD. Treatment is delayed, especially in younger patients, CVD is not adequately investigated, compression therapy is not sufficiently used and surgical treatment is performed for cosmetic reasons.
Venopharmaceuticals are used regularly by only two thirds of patients. These results point to the need to improve the diagnosis and treatment of CVD, especially in the early stages.