The Ulcerated Leg Severity Assessment score for prediction of venous leg ulcer healing
Autor: | S R Kulkarni, C. Wakely, Mark R. Whyman, J. Minor, Keith R. Poskitt, Manjit S. Gohel |
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Rok vydání: | 2007 |
Předmět: |
Adult
Male medicine.medical_specialty Severity of Illness Index Venous leg ulcer Varicose Ulcer law.invention Randomized controlled trial Predictive Value of Tests Risk Factors law Severity of illness medicine Humans Prospective Studies Prospective cohort study Aged Aged 80 and over Wound Healing business.industry Proportional hazards model Hazard ratio Middle Aged medicine.disease Surgery Log-rank test Predictive value of tests Regression Analysis Female business Stockings Compression |
Zdroj: | British Journal of Surgery. 94:189-193 |
ISSN: | 1365-2168 0007-1323 |
DOI: | 10.1002/bjs.5597 |
Popis: | Background The aim of the study was to create a reliable scoring system for the prediction of venous ulcer healing in patients treated with compression. Methods A prospective baseline study to identify risk factors for venous ulcer healing was undertaken between March 1999 and August 2001. All patients were treated with multilayer compression. A number of variables were related to 24-week healing rates. A Cox regression model was used to identify risk factors that predicted ulcer healing, from which a scoring system was developed and validated prospectively between February 2004 and March 2005. Results In the baseline study of 229 patients, patient age, ulcer chronicity and venous refill time (VRT) of 20 s or less were identified as risk factors. Using these factors and hazard ratios from the Cox regression analysis, the following formula was devised: Ulcerated Leg Severity Assessment (ULSA) score = age + chronicity − 50 (when VRT is greater than 20 s). Patients with an ULSA score of 50 or less had higher 24-week ulcer healing rates than those with higher scores in both the baseline study (P < 0·001, log rank test) and the validation study performed in 86 patients (P = 0·007, log rank test). Conclusion The ULSA score may help to identify patients with venous ulcers unlikely to respond to conventional treatment who could be offered alternative therapy. |
Databáze: | OpenAIRE |
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