Varicose veins are among the most prevalent medical conditions in western populations, with a prevalence estimated at 25--35% in women and 10--20% in men. Until now, few studies have regarded varicose veins as a distinct clinical entity and have investigated specific risk factors. Their consequences for the patients have not been adequately investigated. The main objective of this thesis was to examine the association between varicose veins and specific risk indicators and outcomes, taking into account the effects of more severe venous disorders often found in combination with varicose veins. This work is based on the VEnous INsufficiency Epidemiological and economical Study (VEINES), a one-year cohort study on venous disorders carried out in Belgium, France, Italy and Quebec. It included 1531 patients sampled among 5688 consecutive patients consulting a physician for a venous disorder. A sub-sample of 150 patients were referred to specialists for clinical examination and duplex investigation of venous incompetence. This study illustrated the problems of the diagnosis and classification of varicose veins, with a specificity of 45% for the diagnosis made by general practitioners. In a case-control analysis, the strongest risk indicators of varicose veins were pregnancy, age and family history. No association was found with other hypothesised determinants (obesity, smoking, history of thrombophlebitis, blood group A). Results of duplex studies support the hypothesis of a distal onset of venous reflux and varicose veins. / Using a classification of varicose veins proposed to take account the concomitant presence of other signs of venous disease, varicose veins alone had no impact on a symptom score and on generic (SF-36) and disease-specific quality of life scores. The results suggest that symptoms and presence of varicose veins are independent outcomes, which has implications for clinical practice. A detailed analysis of health service utilisation performed in Belgium also showed that both are independent predictors of resource use.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.36627 |
| Date | January 1999 |
| Creators | Kurz, Xavier. |
| Contributors | Abenhaim, L. (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: 001740224, proquestno: NQ64594, Theses scanned by UMI/ProQuest. |
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