Prevalence, complications, and risk factors of varicosity among primary care patients

Introduction: Data on prevalence of varicose veins vary widely in epidemiological studies as a result of different evaluation and selection criteria. The aim of this study was to investigate the prevalence of varicosity, its risk factors, and frequency of local complications in German primary care. Patients and methods: Over a three year period (1.7.2008-30.6.2011) the electronic medical records of 87,548 patients from 32 general practice settings extracted from the CONTENT primary care database were analysed. A total of 2,721 patients with varicose veins were found based on the ICD-10 codes 183.0-183.9. Leg ulcers and local infections were identified by the ICD-10 codes 183.0,183.1 and 183.2. The analysis of risk factors was performed using multivariable binary regression. Results: The prevalence of varicose veins averaged 3.1% (males 0.86%, females 2.25%) and correlated with age. Leg ulcers or thrombophlebitis were recorded in approximately 10% of patients with varicose veins. Most important risk factors were older age (OR 1.02 [95% CI 1.016 to 1.022), p<0.001), female gender (OR 1.76 [95% CI 1.60 to 1.92], p<0.001) and cardiovascular diseases (OR 2.02 [95% CI 1.84 to 2.11], p<0.001). Conclusions: Varicose veins were coded in 3.1 % of their patients by general practitioners and therefore perceived as a medical problem. The comparison with similar primary care data indicates an 'underestimation' of the true prevalence in German general practice settings. Local complications such as thrombophlebitis and leg ulcers occurred in approximately 10% of patients with varicosity and were related to older age and risk-enhancing chronic diseases.