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Descriptive analyses of patients with chronic venous insufficiency undergoing surgical treatment in ACS-National Surgical Quality Improvement Program (NSQIP) database
*Mohammad H Eslami1, *Thomas Nicolas Carruthers1, *Denis Rybin2, *Gheorghe Doros2, Alik Farber1
1Boston University School of Medicine, Boston, MA;2Boston University School of Public Health, Boston, MA

Introduction: Chronic venous insufficiency (CVI) is the most common reason to see a vascular surgeon. In this study we perform descriptive analyses of patients who underwent surgical repair using ACS-NSQIP data.

Methods: ACS-NSQIP dataset was queried using ICD-9 diagnostic codes for CVI. Two separate analyses were performed; first based on the two types of surgery these patients had (vein stripping (VV) vs. endovenous procedures (EV)) and second based on the presence or absence of venous ulcer at presentation. Comparisons among the two groups were performed by either using Chi-squared test (categorical variables) or t-test (continuous variables) and the differences were deemed significant if p<.05.

Results: We identified a sample of 2810 patients. Vascular surgeons performed 77.2% of all cases but they performed a significantly higher rate of VV and lower rate of EV procedures (p<.05). Number of cases increased annually but VV outpaced EV by a factor of ~2 (62.7% vs. 37.3%; p<.05). Patients who underwent EV were heavier and had a higher prevalence of venous ulcer. Most common complication of surgery was superficial surgical site infection significantly more common among VV patients (p<.05). At presentation, 15.6% of patients had venous ulcer. Male (55.4% vs. 28.1%, p<.001), older (57.6+14.0 vs. 51.3+13.4, p<.001) and heavier patients (214+62.2 lbs. vs.180+46.8 lbs., p<.001) were more commonly present among the ulcerated group.
Male patients present more commonly in a delayed fashion with ulcer. Although vascular surgeons perform majority of venous procedures, they lose their market share of EV procedures. Public education about CVI by vascular surgical societies may change both of these trends.

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