SAN DIEGO — In its second year, the National Screening Program for Venous Disease conducted free clinics in 40 states, and more than half the persons screened were found to be at risk of a venous thromboembolism if put in a conducive situation, Dr. Robert B. McLafferty said at the annual meeting of the American Venous Forum.
“There has been extreme and rapid growth,” said Dr. McLafferty, professor of vascular surgery at Southern Illinois University, Springfield. In the second year, 149 centers conducted free screening clinics versus 17 centers in the first year.
As with the first year's screening, data from the 56 clinics that have reported their results so far showed a high rate of risk and disease among those screened, with 57% deemed to be at high or very high risk of a venous thromboembolism if placed in a risky situation, defined as a surgical procedure, major injury or hospitalization, malignancy, or prolonged immobility.
This is not surprising given that the mean age of participants was 60 years, 40% were overweight, and the second most common reason participants came to the clinics was varicose veins (30%), Dr. McLafferty said.
In all, 17% had a quality of life that was very limited by venous symptoms, or had probable disease. Participants were mostly white and female (both about 80%).
Differences from the first year were that a slightly higher percentage of participants were considered CEAP (clinical, etiologic, anatomic, pathophysiologic) class 0 (29% versus 20%), and fewer were overweight (40% had a body mass index over 25, versus 67%), Dr. McLafferty said. Otherwise, there were few differences, “even though we have tripled the number of people screened,” he added. One in 20 participants had segments of obstruction in the veins examined by ultrasound, and almost 40% had one or more segments of reflux.
The results of the first year's screening program were recently published (J. Vasc. Surg. 2007;45:142–8).
Participants filled out a demographic questionnaire and a quality of life form. They had a venous thromboembolism risk assessment using a standardized tool, and an abbreviated ultrasound examination that looked at the common femoral vein, the saphenofemoral junction, and the popliteal vein above the knee. Lastly, the participants were examined by trained professionals or physicians to classify their lower extremities using the CEAP classification system, and were given an exit interview detailing the findings of their exams.
The screening program is the brainchild of the American Venous Forum, with assistance from the American Vascular Association.
The two annual screening programs have taken place during a week in early November.
Of those screened, 57% were at high or very high risk of a venous thromboembolism if placed in a risky situation. DR. MCLAFFERTY