Venous leg symptoms, ecchymosis, and coldness in patients with peripheral varicose vein: A multicenter assessment and validation study (VEIN-VIOLET study)

Vascular. 2021 Oct;29(5):767-775. doi: 10.1177/1708538120980207. Epub 2020 Dec 18.

Abstract

Objectives: We aimed to evaluate peripheral varicose vein symptoms including ecchymosis and coldness by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire.

Methods: A total of 1120 patients were enrolled to the analysis after the exclusion of 199 patients who did not match the inclusion criteria. Patients were asked to answer the VEINES-Sym questionnaire and questions about ecchymosis and coldness. Scores of ecchymosis and coldness were calculated similar to VEINES-Sym questionnaire. Classifications of peripheral varicose vein were made according to the clinical part of clinical, etiological, anatomical, and pathophysiological classification system and patients with grade 2 or higher were considered as positive for peripheral varicose vein.

Results: Frequency of symptoms present in the VEINES-Sym instrument, ecchymosis and coldness were significantly higher in patients with peripheral varicose vein. Mean score of each symptom was significantly lower in peripheral varicose vein patients including scores of ecchymosis and coldness. Logistic regression analysis revealed that presence of hemorrhoids and all symptoms in VEINES-Sym questionnaire except restless leg were significantly and independently associated with peripheral varicose vein. Besides, ecchymosis (odds ratio: 2.04, 95% confidence interval: 1.34-3.08, p = 0.008) but not coldness was significantly and independently associated with peripheral varicose vein. There was also significant correlation of VEINES-Sym score with ecchymosis (r = 0.43, p < 0.001) and coldness (r = 0.47, p < 0.001).

Conclusions: Venous leg symptoms present in VEINES-Sym questionnaire except restless legs, presence of hemorrhoids and ecchymosis are significantly and independently associated with peripheral varicose vein. Not only ecchymosis but also coldness has shown an independent association with total VEINES-Sym score.

Keywords: Peripheral varicose vein; ecchymosis; leg diseases; symptoms.

Publication types

  • Multicenter Study
  • Observational Study
  • Validation Study

MeSH terms

  • Adult
  • Body Temperature Regulation*
  • Ecchymosis / etiology*
  • Female
  • Hemorrhoids / diagnosis
  • Hemorrhoids / etiology
  • Humans
  • Lower Extremity / blood supply*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Reproducibility of Results
  • Restless Legs Syndrome / diagnosis
  • Restless Legs Syndrome / etiology
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires*
  • Turkey
  • Varicose Veins / complications
  • Varicose Veins / diagnosis*
  • Varicose Veins / physiopathology
  • Veins / physiopathology*
  • Venous Insufficiency / complications
  • Venous Insufficiency / diagnosis*
  • Venous Insufficiency / physiopathology