Comprehensive Lymphedema Program, UPMC, Pittsburgh, Pennsylvania, USA.
Department of Food and Engineering, Faculty of Engineering, Izmir Institute of Technology, Izmir, Turkey.
Lymphat Res Biol. 2022 Jun;20(3):315-318. doi: 10.1089/lrb.2020.0086. Epub 2021 Oct 14.
Lymphedema (LE) is a chronic condition that requires lifelong treatment. Although pneumatic compression therapy (PCT) is one treatment option, current algorithms consider it as an adjunct to standard LE The purpose of this study is to evaluate the importance of adapting PCT for lower extremity LE (LEL) in relation to patient compliance and rate of infection. Patients diagnosed with LEL were followed prospectively. Patient demographics, comorbidities, treatment modality, compliance, infection due to LE, and hospitalization were recorded. LEL patients with no-PCT were also recorded in the same time period to evaluate the treatment compliance and the need for physical therapy visits. The no-PCT group received the standard LE care, whereas the PCT group received the standard LE care plus a new-generation pneumatic compression device. A total of 69 patients were enrolled in this study. The PCT group had 50 patients and no-PCT group had 19 patients. The PCT group had median 58.5 months of LE symptoms, while non-PCT patients had median 23 months of LE symptoms ( = 0.11). Infection rates decreased by 32% and hospitalizations due to infection decreased by 14% after PCT treatment had been initiated. Physical therapy needs decreased by 24% after PCT use. At median 18 months, follow-up compliance for PCT was 84%, but compliance for manual lymphatic drainage was almost half (53%) in no-PCT group. PCT leads to a decrease in infection rate, hospital admissions, and physical therapy (PT) visits in clinically significant LEL. Although there is no cost calculation in this study, it can be correlated to significant cost savings due to a reduction of infection and hospitalization and the need for PT visits. Adoption of PCT offers a superior value proposition to not only patients but also the health care system. Cost analysis should be followed.
淋巴水肿（LE）是一种需要终身治疗的慢性疾病。虽然气动压缩治疗（PCT）是一种治疗选择，但目前的算法将其视为 LE 的辅助治疗。本研究旨在评估根据患者的依从性和感染率，调整下肢淋巴水肿（LEL）的 PCT 的重要性。前瞻性随访诊断为 LEL 的患者。记录患者的人口统计学、合并症、治疗方式、依从性、LE 感染和住院情况。在同一时期还记录了无 PCT 的 LEL 患者，以评估治疗依从性和物理治疗就诊的需求。无 PCT 组接受标准 LE 护理，而 PCT 组接受标准 LE 护理加新一代气动压缩设备。本研究共纳入 69 例患者。PCT 组 50 例，无 PCT 组 19 例。PCT 组 LE 症状的中位数为 58.5 个月，而非 PCT 患者为 23 个月（=0.11）。开始 PCT 治疗后，感染率下降了 32%，因感染住院的人数减少了 14%。使用 PCT 后，物理治疗的需求减少了 24%。在中位数为 18 个月的随访中，PCT 的依从率为 84%，而无 PCT 组的手动淋巴引流依从率几乎减半（53%）。PCT 可降低临床上显著的 LEL 的感染率、住院率和物理治疗（PT）就诊率。尽管本研究中没有进行成本计算，但由于感染和住院率降低以及 PT 就诊需求减少，可能会带来显著的成本节约。采用 PCT 不仅为患者，也为医疗保健系统提供了更高的价值主张。应进行成本分析。
