Chen Chu Wen, Cai Yu T, Wang Jia R, Wu Zhou P, Liu Yang, Huang Bing, Yang Yi, Yuan Ding, Ma Yu K, Zhao Ji C
Department of vascular surgery, West China Hospital, Sichuan University, Chengdu, China.
Department of ambulatory center, West China Hospital, Sichuan University, Chengdu, China.
Front Surg. 2022 Apr 4;9:801729. doi: 10.3389/fsurg.2022.801729. eCollection 2022.
The effects of body mass index (BMI) on the outcome of high ligation and stripping (HLS) in an ambulatory center remain unclear. This study aims to investigate the outcomes of HLS in an ambulatory center based on BMI in the Chinese population.
This was a prospective cohort study with mid-term follow-up.
170 eligible patients were included in the study and the data of Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification, Venous Clinical Severity Score (VCSS), Visual Analogue Score (VAS), Aberdeen Varicose Veins Questionnaire (AVVQ), Quality of Recovery (QoR-15), and postoperative complications at predetermined time points were collected.
A total of 170 patients (236 limbs) with a mean age of 53.87 ± 9.96 years (range, 24-80 years) and a mean BMI of 23.86 ± 2.96 kg/m were included. Of the group, 50.6% were women, and 66 patients received bilateral procedures. Through curve fitting, a BMI less than 28 and a BMI of 28 or higher were found to have a negative [-0.1 (-0.3, 0.1) 0.296] and positive [0.7 (0.2, 1.2) 0.006] relationship trend, respectively, with the improvement of VCSS at 6 weeks after surgery. Through smooth curve fitting, BMI was shown to have a negative relationship trend on the improvement of VCSS at 6 months after surgery. After multivariable risk adjustment for potential confounding factors, BMI was not found to be associated with the improvement of VCSS and AVVQ at 6 weeks after surgery, as well as the improvement of AVVQ at 6 months after surgery (all -values >0.05). Six months after surgery, BMI was shown to have a negative relationship trend on the improvement of VCSS, and obese patients showed lower VCSS improvement than patients of normal BMI [-1.3 (-1.9, -0.7) <0.0001]. Six weeks after surgery, postoperative complications such as paresthesia were found to be significantly higher in the obese group than in the non-obese group ( < 0.05). At 6 months after surgery, the obese group showed significantly higher complications of the legs compared with the normal BMI group ( < 0.05).
Our results showed that obesity is a risk factor for prognosis and postoperative complications following ambulatory HLS.
体重指数（BMI）对门诊中心高位结扎剥脱术（HLS）结局的影响尚不清楚。本研究旨在基于BMI调查中国人群门诊中心HLS的结局。
这是一项进行中期随访的前瞻性队列研究。
170例符合条件的患者纳入研究，收集预定时间点的临床、病因、解剖和病理生理学（CEAP）分类、静脉临床严重程度评分（VCSS）、视觉模拟评分（VAS）、阿伯丁静脉曲张问卷（AVVQ）、恢复质量（QoR-15）及术后并发症的数据。
共纳入170例患者（236条肢体），平均年龄53.87±9.96岁（范围24 - 80岁），平均BMI为23.86±2.96kg/m²。该组中50.6%为女性，66例接受双侧手术。通过曲线拟合发现，BMI小于28和BMI为28及以上者，分别与术后6周时VCSS的改善呈负相关[-0.1（-0.3，0.1），P = 0.296]和正相关[0.7（0.2，1.2），P = 0.006]趋势。通过平滑曲线拟合显示，BMI与术后6个月时VCSS的改善呈负相关趋势。对潜在混杂因素进行多变量风险调整后，未发现BMI与术后6周时VCSS及AVVQ改善以及术后6个月时AVVQ改善相关（所有P值>0.05）。术后6个月，BMI与VCSS改善呈负相关趋势，肥胖患者的VCSS改善低于正常BMI患者[-1.3（-1.9，-0.7），P<0.0001]。术后6周，肥胖组感觉异常等术后并发症显著高于非肥胖组（P<0.05）。术后6个月，肥胖组腿部并发症显著高于正常BMI组（P<0.05）。
我们的结果表明，肥胖是门诊HLS术后预后及并发症的危险因素。
