Ethics
Ethical approval was not sought, in keeping with institutional policy exempting audits and service improvement reviews from ethical approval.
Results
Over the four-year study period there were 218 VLU-related unplanned, inpatient hospital admissions throughout the Saolta Group. Of these, 122 were coded “Varicose veins of lower extremities with both ulcer and inflammation”, while 96 were coded “Varicose veins of lower extremities with ulcer”. Overall 131 (59%) were female and (41%) male, and the median age was 78.9(69.1-84.9). There was no significant difference in likelihood of inflammation being present based on sex (p=.09) or age (p=.15).
In total, VLU patients accounted for a total of 2,529 inpatient bed-days, with 4.5(2-6) admissions per month, and a median hospital stay of 7(4-13) days per month throughout this period. Each month, a median 40.5(21-71) bed-days were devoted to patients with venous ulceration.
Those with ulcers with inflammation or infection accounted for 1,454days (57.5%), with a median 8(4-14) days per unplanned admission, while those without accounted for 1,075 days (42.5%), median 7(3-13) per unplanned admission. There was no significant difference in median length of stay between these groups (p=.28).
Since commencement of the rapid access clinic, 161 patients were seen with 183 ulcers assessed. 53 of these ulcers were recurrent, and 8 of these recurrences occurred in legs previously treated in the clinic. Demographic data is presented in table 1. In this time, 108/183(59%) have received endovenous treatment for reflux. Of those, 21(11.5%) both axial ablation and sclerosant foam were performed for 21(11.5%) of ulcers, 42(22.9%) received foam only, and 55(30%) underwent axial ablation. 46(25.1%) ulcers were managed with compression alone. The remainder received no treatment of reflux during the study period.