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. 2019 Feb;16(1):256-265.
doi: 10.1111/iwj.13026. Epub 2018 Nov 4.

Epidemiology of venous leg ulcers in primary health care: Incidence and prevalence in a health centre-A time series study (2010-2014)

Miriam Berenguer Pérez  1 , Pablo López-Casanova  1   2 , Raquel Sarabia Lavín  3 , Héctor González de la Torre  4 , José Verdú-Soriano  1
Affiliations

Epidemiology of venous leg ulcers in primary health care: Incidence and prevalence in a health centre-A time series study (2010-2014)

Miriam Berenguer Pérez et al. Int Wound J. 2019 Feb.

Abstract

The aims of the study were to describe and analyse the temporal trend of the prevalence and incidence of venous leg ulcers (VLU) over the years 2010 to 2014, to determine healing times and temporal trends in the study period, and to evaluate related aspects such as the use of the Ankle-Brachial Pressure Index (ABPI) in a primary care health centre. This was a retrospective study based on a time series (years 2010-2014) of the prevalence and incidence of VLUs in people aged over 40 years in a primary care centre in Barcelona City. We reviewed 3920 electronic health records selecting patients, per year (2010-2014), with VLUs based on the ICD-10 diagnoses. For prevalence, we took into account any patient with an active VLU in the year of study. For incidence, we took into account patients with a new VLU in the year of study. A descriptive analysis was carried out based on each of the collected variables. The variables were examined according to the years of study (time series) by one-factor analysis of variance (anova) or Kruskal-Wallis non-parametric test, as appropriate. A survival analysis by Kaplan-Meier curves and log-rank test was also performed. A total of 139 patients met the VLU criteria. Among them, only 79.2% were classified as having a VLU and had a correct ICD diagnosis. The prevalence and incidence increased over the years, doubling in patients aged over 65 years. Incidence increased from 0.5 new cases per 1000 people/year in 2010 to 1 new case for every 1000 people/year in 2014. Moreover, the prevalence ranged between 0.8 and 2.2 patients with VLU for every 1000 people/year. During the study period, a total of 84.2% of the VLUs healed (117/139 VLU). Regarding average annual time to healing, the trend indicates that lesions took less time to heal (Kruskal-Wallis test, P = 0.004), ranging between 453,9 weeks in 2005 to 19 weeks in 2014. The use of ABPI also evolved and was found to be increasingly performed prior to the appearance of the lesion. The epidemiological profile of people affected by VLUs continues to be, mainly, that of women of an advanced age, over 70 years. The frequency of VLU occurrence rose continually over the years, but healing took less time, and use of ABPI improved. Assigning a reference nurse in the wounds unit and the organisational structure around this problem may have an influence on improving care and the approach to these types of lesions.

Keywords: incidence; nursing; prevalence; primary care health; venous leg ulcers.

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Conflict of interest statement

The authors have no conflicts of interest to report.

Figures

Figure 1
Figure 1
Distribution of gender of patients with venous leg ulcers (VLU). Trend over years
Figure 2
Figure 2
Mean age of patients with venous leg ulcers (VLU). Trend over years
Figure 3
Figure 3
Prevalence trend in the period 2010 to 2014
Figure 4
Figure 4
Incidence trend in the period 2010 to 2014
Figure 5
Figure 5
Venous leg ulcer (VLU) healing trend over 2010 to 2014
Figure 6
Figure 6
Average annual time to healing
Figure 7
Figure 7
Survival curves of healing, comparing venous leg ulcer (VLU) with origin before 2010 and those VLUs that developed in the period 2010 to 2014
Figure 8
Figure 8
Survival curve of healing (all cases), focusing on healing likelihood at week 12 and 24
Figure 9
Figure 9
Mean time elapsed between the Ankle‐Brachial Pressure Index (ABPI) test and venous leg ulcer (VLU) diagnostic over time
See this image and copyright information in PMC

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