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Estudo prospetivo do impacto da cirurgia clássica de varizes na qualidade de vida dos doentes com doença venosa crónica
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Introdução: A DVC é uma patologia bastante prevalente que condiciona altas taxas de morbilidade, importantes prejuízos de QdV e se associa a elevados custos para os sistemas de saúde, representando um enorme problema de saúde pública, frequentemente subvalorizado. Nos hospitais públicos portugueses, a cirurgia clássica de varizes é a técnica cirúrgica mais frequentemente realizada para o tratamento da DVC. A avaliação do sucesso terapêutico depende, além dos instrumentos tipicamente utilizados baseados na perspetiva do clínico, da aplicação de PROM. Objetivo: Avaliar de forma prospetiva o impacto, a curto prazo, da cirurgia clássica de varizes e estudar o impacto dos fatores de risco de DVC na qualidade de vida dos doentes com DVC. Material e Métodos: Dos 231 doentes propostos para cirurgia clássica de varizes na ULS Santa Maria, entre dezembro de 2023 e fevereiro de 2024, aqueles que aceitaram participar na investigação preencheram de forma autónoma três exemplares do questionário CIVIQ-20, destinados a avaliar a QdV no período pré-cirúrgico, no primeiro e no segundo mês pós-cirúrgico, e responderam a um conjunto de questões demográficas e de história da doença. Os critérios de inclusão contemplavam: idade superior a 18 anos, cirurgias realizadas apenas durante o período estudado, o correto preenchimento dos quatro documentos e uma classificação Basic CEAP entre C0 e C4. A análise estatística foi realizada com o software IBM SPSS Statistics24 e foram considerados estatisticamente significativos valores p<0,05. Conclusão: A cirurgia clássica de varizes produz melhorias, estatisticamente significativas, nos primeiros dois meses de pós-operatório em todas as dimensões da QdV, sendo a dor a dimensão que descreve o maior impacto cirúrgico. A presença de dor foi ainda considerada o principal determinante para a perceção de uma má QdV précirúrgica. O género feminino, a doença prolongada e a história familiar descreveram uma relação estatisticamente significativa com a QdV pré-cirúrgica.
Introduction: CVD is a highly prevalent that causes high morbidity rates, significant QoL impairment and is associated with high health system’s costs, representing a huge and often underestimated public health problem. The classic varicose vein surgery is the most common surgical technique used to treat CVD in portuguese public hospitals. In addition to the typically used instruments, based on the clinician's perspective, the evaluation of therapeutic success depends on the application of PROM. Objective: To prospectively assess the short-term impact of classic varicose vein surgery and to study the impact of risk factors of CVD on patient’s quality of life. Methods: Of the 231 patients proposed for classic varicose vein surgery at ULS Santa Maria between December 2023 and February 2024, those who agreed to take part in the research, filled in three copies of the CIVIQ-20, designed to assess the QoL on the pre-surgical period, on the first and on the second post-surgical month, and answered a set of demographic and disease history questions, in an independently way. The inclusion criteria were: age over 18, only surgeries performed during the study period, correct fulfilment of the four documents and a Basic CEAP classification between C0 and C4. Statistical analysis was carried out using IBM SPSS Statistics24 software and p-values < 0.05 were considered statistically significant. Conclusion: Classic varicose vein surgery produces statistically significant improvements in the first two months post-operatively in all dimensions of QoL, with pain being the dimension that describes the greatest surgical impact. The presence of pain was also considered the main determinant for a pre-surgical poor QoL perception. Female gender, long-term disease and family history described a statistically significant relationship with pre-surgical QoL.
Introduction: CVD is a highly prevalent that causes high morbidity rates, significant QoL impairment and is associated with high health system’s costs, representing a huge and often underestimated public health problem. The classic varicose vein surgery is the most common surgical technique used to treat CVD in portuguese public hospitals. In addition to the typically used instruments, based on the clinician's perspective, the evaluation of therapeutic success depends on the application of PROM. Objective: To prospectively assess the short-term impact of classic varicose vein surgery and to study the impact of risk factors of CVD on patient’s quality of life. Methods: Of the 231 patients proposed for classic varicose vein surgery at ULS Santa Maria between December 2023 and February 2024, those who agreed to take part in the research, filled in three copies of the CIVIQ-20, designed to assess the QoL on the pre-surgical period, on the first and on the second post-surgical month, and answered a set of demographic and disease history questions, in an independently way. The inclusion criteria were: age over 18, only surgeries performed during the study period, correct fulfilment of the four documents and a Basic CEAP classification between C0 and C4. Statistical analysis was carried out using IBM SPSS Statistics24 software and p-values < 0.05 were considered statistically significant. Conclusion: Classic varicose vein surgery produces statistically significant improvements in the first two months post-operatively in all dimensions of QoL, with pain being the dimension that describes the greatest surgical impact. The presence of pain was also considered the main determinant for a pre-surgical poor QoL perception. Female gender, long-term disease and family history described a statistically significant relationship with pre-surgical QoL.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2024
Palavras-chave
Doença venosa crónica Qualidade de vida Cirurgia clássica de varizes Chronic venous insufficiency questionnaire (CIVIQ-20) Patient reported outcome measures (PROM) Cirurgia vascular