gms | German Medical Science

Background: Chronic venous diseases (CVI) are one of the most frequent diseases in populations of industrialized countries, but only a few studies have addressed the burden of disease in the general population. Our study investigates the incidence and symptoms of CVI in the German population.

Material and methods: Data are derived from the Bonn Vein Study, a population-based cohort study (2000-2008) which included 3072 participants between 18 and 79 years, residing in Bonn and two rural adjacent townships. All participants filled in a questionnaire regarding socio-economic status, lifestyle, medical history and quality of life. Trained examiners conducted an interview concerning the phlebological history and performed a clinical examination including a duplex-sonography. Venous diseases were judged by CEAP-classification (including the clinical score evaluating the symptoms of CVI and the disability score). CVI was defined as at least one limb classified between C3 and C6.

Results: Response at follow-up after a mean of 6.6 years was 84.6%. The full cohort included 740 men and 916 women without CVI at baseline. 216 cases of new CVI were diagnosed at follow-up. The incidence was 14% (95%-CI: 11% - 16%) in women and 13% (95%-CI: 11% -16%) in men over a 6.6 year period and increased in higher age groups. The most common symptoms of CVI were the edema (81%); ulcers were found in only 1%. 19% of all incident CVI cases had moderate pain in the legs and 5% had severe pain, requiring analgesics. Disability scoring showed that 60% had asymptomatic legs, 32% had symptomatic legs, but not using medical compression stockings at work, whereas 5% needed compression therapy. 3% were unable to work due to their symptoms.

Discussion: Among the adult population we predict 1,840 new cases of CVI per 100,000 in one year which means a large disease burden for a population of the size of Germany.