Kahn Susan R, M'lan Cyr E, Lamping Donna L, Kurz Xavier, Bérard Anick, Abenhaim Lucien A
Center for Clinical Epidemiology & Community Studies, Sir Mortimer B Davis Jewish General Hospital, Department of Epidemiology and Biostatistics, McGill University, Montreal, Que, Canada.
J Vasc Surg. 2004 Apr;39(4):823-8. doi: 10.1016/j.jvs.2003.12.007.
The CEAP (clinical, etiologic, anatomic, pathophysiologic) clinical classification for chronic venous disease (CVD) is based on physician-evaluated clinical signs of CVD. The relationship between CEAP clinical classification and patient-perceived quality of life (QOL) has not been evaluated, but is important for the selection and interpretation of outcomes in clinical studies of patients with CVD. The purpose of this study was to evaluate whether CVD, as classified with CEAP, is related to patient-reported QOL, and to identify patient characteristics associated with CEAP class and QOL that need to be considered when interpreting outcomes in CVD.
The Venous Insufficiency Epidemiologic and Economic Study (VEINES) population is an international cohort of 1531 patients with CVD recruited in Belgium, France, Italy, and Canada. At the baseline visit patients were categorized into one of seven CEAP clinical categories on the basis of a clinical examination, and completed standardized generic (Short-Form Health Survey, 36 items [SF-36]) and venous disease-specific (QOL [VEINES-QOL] and symptom severity [VEINES-Sym]) QOL questionnaires. Multivariate analyses were used to examine the relationship between CEAP class and QOL.
The proportion of patients in the seven CEAP classes (class 0-6) was 3.8%, 13.3%, 24.1%, 12.8%, 36.4%, 7.3%, and 2.3%, respectively. In univariate analyses, SF-36 Physical Component Summary scores and VEINES-QOL and VEINES-Sym scores decreased significantly (ie, poorer QOL) with increasing CEAP class. Multivariate analyses controlling for age, sex, country, education, body mass index, years since CVD onset and comorbid conditions confirmed findings for VEINES-QOL and VEINES-Sym (P<.0001 and P<.0001, respectively).
Physician-evaluated clinical category, based on the CEAP classification, predicts patient-reported QOL and symptom severity in CVD.
慢性静脉疾病（CVD）的CEAP（临床、病因、解剖、病理生理）临床分类基于医生评估的CVD临床体征。CEAP临床分类与患者自我感知的生活质量（QOL）之间的关系尚未得到评估，但对于CVD患者临床研究结果的选择和解释很重要。本研究的目的是评估按照CEAP分类的CVD是否与患者报告的QOL相关，并确定在解释CVD结果时需要考虑的与CEAP类别和QOL相关的患者特征。
静脉功能不全流行病学和经济学研究（VEINES）人群是一个由1531名CVD患者组成的国际队列，这些患者来自比利时、法国、意大利和加拿大。在基线访视时，根据临床检查将患者分为七个CEAP临床类别之一，并完成标准化的通用（简短健康调查，36项 [SF-36]）和静脉疾病特异性（QOL [VEINES-QOL] 和症状严重程度 [VEINES-Sym]）QOL问卷。采用多变量分析来研究CEAP类别与QOL之间的关系。
七个CEAP类别（0-6级）的患者比例分别为3.8%、13.3%、24.1%、12.8%、36.4%、7.3%和2.3%。在单变量分析中，随着CEAP类别增加，SF-36身体成分汇总得分以及VEINES-QOL和VEINES-Sym得分显著降低（即QOL较差）。在控制年龄、性别、国家、教育程度、体重指数、CVD发病后的年数和合并症的多变量分析中，证实了VEINES-QOL和VEINES-Sym的结果（分别为P<0.0001和P<0.0001）。
基于CEAP分类的医生评估临床类别可预测CVD患者报告的QOL和症状严重程度。
