Objective. In order to prevent the last stages of chronic venous insufficiency of the lower limbs, a case-control study was performed to identify and quantify demographic and clinical risk factors for venous ulcer disease. A particular attention was given to history of superficial as well as deep vein thrombosis. / Patients and method. Patients presenting to a participating vascular surgery department between January and December 1997 with a first open venous ulcer served as cases. Controls were sampled among patients with sub-acute conditions such as back pain, cold, headache/migraine, sore throat and mild ear infections and were matched on referral, age (+/-5 years), and gender. Subjects were eligible if they were 18 years or older and had a good understanding of English or French. They were excluded if they had non-palpable pedal pulse or any chronic active diseases such as cancer or AIDS. Cases' status were ascertained by participating vascular surgeons using a standardized and objective protocol. Data on risk factors were collected with a valid and reliable interviewer-administered questionnaire developed and tested for face validity and reliability before the beginning of the study. The questionnaire has 54 items and explores areas such as obesity, disease antecedents, services utilization, lifestyles, work history, as well as pregnancy and menopause status in women. Inter-rater reliability was high and above 75% for all 54 items. Leg circumferences were measured with a Leg-O-Meter and patients were asked to fill a quality of life questionnaire. / Results. The mean age of participants was 61 years for cases (n = 102) and 59 years for controls (n = 200). History of deep vein thrombosis (DVT) (OR = 17.6 [2.9, 106.8]95%), strenuous exercise (OR = 8.9 [1.1, 72.0]95%) and family history of venous insufficiency on the mother's side (OR = 6.8 [1.9, 24.3]95%) were found to be significant predictors of venous ulcers in matched multivariate logistic regression analysis adjusted for body mass index (kg/height (m2)), history of pulmonary embolism, cardiovascular diseases, hypertension, fracture, smoking history, work, number of physician visits in past year, and education. / Clinical implications. Venous ulcers are a major public health problem mostly because of the cost associated with treating them. Our study suggests that prevention and adequate treatment of DVT, and monitoring of family history and physical activity will lead to ulcer prevention. This is especially important since there are no effective treatments to prevent ulcer recurrence at the present time.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.35575 |
| Date | January 1999 |
| Creators | Bérard, Anick. |
| Contributors | Abenhaim, Lucien (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001740483, proquestno: NQ64513, Theses scanned by UMI/ProQuest. |
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