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Outcomes Of Venous Leg Ulcer Healing And Recurrence In Elderly Patients
Joseph P. Hart
1,
Mark G. Davies, MD PhD MBA2.
1MCW, Milwaukee, WI, USA,
2Ascension Health, Waco, TX, USA.
Objective: Chronic venous disease and associated venous leg ulcer (VLU) remain an ongoing problem. The aim of this study was to analyze the impact of Age and the Geriatric Nutritional Risk Index on the outcomes of patients presenting with and undergoing treatment for primary VLU..
Methods: Between 2014 and 2024, a database of patients presenting with a primary VLU in the presence of superficial truncal venous incompetence, and without total deep venous incompetence on duplex imaging. From this cohort, “elderly" individuals aged 65 years and older were selected and categorized as "early elderly" (Early, ages 65 to 74 years) or "late elderly" (Late, ages 75 years and above). The Geriatric Nutritional Risk index (GNRI) is derived from albumen (ALB), body weight, and height (GNRI = 14.89 × ALB (g/dL) + 41.7 × (current body weight [kg] / 22 × height [m]
2)) GNRI can be categorized as ≥ 98, No Risk; 92-98, Low Risk; < 92 High Risk. Demographics and interventions to affect healing were recorded. The primary outcomes were ulcer healing at 24 weeks and freedom from recurrence within one year.
Results: 534 patients (61% female, age 67 ± 9 years, mean ± SD) presented with an active VLU to the wound care center and/or vascular clinic. 455 patients (85%) were elderly, with 45% considered Early and 55% Late. GNRI identified a significantly higher risk in the late elderly group. Early Elderly patients performed far better than Late elderly in terms of short-term and long-term outcomes. Increasing GNRI risk impacts ulcer healing at 24 weeks and recurrence within one year. in the "late elderly".
Conclusions: The majority of patients presenting with VLU are elderly, with many categorized as late elderly; GNRI severity increased with increasing age. Late elderly patients have significantly worse outcomes after interventions for VLU Categorization of elderly patients linked to GNRI can have a predictive value for outcomes for VLU...
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