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document
A comparison of Villalta-Prandoni scale and venous clinical severity score in the assessment of post thrombotic syndrome . BACKGROUND Post-thrombotic syndrome ( PTS ) is the most important late complication of acute deep venous thrombosis ( DVT ) , with as many as two-thirds of patients developing symptoms of pain , edema , hyperpigmentation , or ulceration . Although several instruments are available for evaluation of the severity of PTS , including the Villalta-Prandoni scale ( VPS ) and Venous Clinical Severity Score ( VCSS ) , no studies have yet compared the 2 instruments . The purpose of this study is to compare the 2 instruments as part of a larger randomized controlled study that assessed the impact of graduated compressive stockings in the prevention of PTS . METHODS Sixty-nine consecutive patients with acute DVT documented by duplex ultrasonography were randomized to treatment with 30-40 mm Hg graduated compressive stockings ( GCS ) or no stockings . Patients were followed clinically at months 1 , 3 , 6 , 12 , 18 , and 24 after the diagnosis of DVT . PTS as defined by the VPS and VCSS were assessed at these follow-up visits . Based upon the VPS , PTS was scored as absent ( score < 3 or 3 without objective criteria ) , mild to moderate ( score ≥3 with 1 objective criteria ) , or severe ( score ≥4 ) . For the VCSS , PTS was considered to be absent ( score ≤3 ) , mild to moderate ( score 4-7 ) , or severe ( score ≥8 ) . The 2 instruments were compared for mild to moderate and severe disease using the Pearson chi-squared test and gamma statistic . RESULTS Good correlation was detected in the ability of VPS and VCSS instruments to detect mild to moderate disease ( gamma statistic = 0.71-0.98 ; P < 0.05 ) . For severe disease , a statistically significant correlation was not found in the ability of the 2 instruments to detect disease ( gamma statistic = 0.5-0.98 ; P > 0.05 ) , especially at 12 and 24 months . CONCLUSION Both VPS and the VCSS scoring systems are important tools in the identification and follow-up of PTS . There exists agreement between the 2 instruments for detecting mild to moderate disease . For severe disease however , VCSS may possibly be a more sensitive instrument .
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Intervention_Other
Villalta-Prandoni scale
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Intervention_Other
venous clinical severity score
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Intervention_Other
Villalta-Prandoni scale ( VPS )
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Intervention_Other
Venous Clinical Severity Score ( VCSS )
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Intervention_Physical
graduated compressive stockings
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Intervention_Physical
30-40 mm Hg graduated compressive stockings ( GCS )
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Intervention_Control
no stockings
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Outcome_Physical
post thrombotic syndrome
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Outcome_Pain
pain
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Outcome_Physical
edema
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Outcome_Physical
hyperpigmentation
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Outcome_Physical
ulceration
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Outcome_Physical
Villalta-Prandoni scale ( VPS )
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Outcome_Physical
Venous Clinical Severity Score ( VCSS )