Factors influencing the decision-making process in the management of superficial venous thrombosis in patients with varicose veins
Keywords:
superficial venous thrombosis, acute varicothrombophlebitis, varicose veins, surgical treatment, decision factorsAbstract
Despite the evidence, surgical treatment continues to be part of the arsenal of curative methods addressed to patients with varicose veins complicated by superficial venous thrombosis (SVT). In a retro-prospective observational study on a group consisting of 190 consecutive patients (195 lower extremities) with SVT, the factors with potential impact on the decision-making process related to the management – inpatient treatment vs. ambulatory; conservative vs. urgent surgery – were evaluated. 153 (80.52%) patients were hospitalized in the surgical wards, the other 37 from the conservatively managed group (n=105) underwent outpatient treatment. The surgical group included 85 observations. It was identified that the doctor’s decision in favor of surgical intervention in the acute phase of SVT, as well as the selection of the ambulatory regimen of conservative treatment, has an empirical character, being significantly influenced (OR>3) by the specialist’s personal experience. Obesity (OR–2.23), thrombosis of the saphenous trunk without involvement of junctions with deep veins (OR–2.31) and the number of comorbidities (OR–0.42) represented the factors with a significant impact on the decision-making process.
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