Prevalence of leg ulceration in a London population

Moffatt, Christine J., Franks, Peter J., Doherty, Debra C., Martin, Ruth, Blewett, Rachel and Floss, F. (2004) Prevalence of leg ulceration in a London population. Quarterly Journal of Medicine, 97 (7). pp. 431-437. ISSN 1460-2393

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Background: Current prevalence estimates of chronic leg ulceration are frequently based on studies from the 1980s. During the last decade, major changes have occurred in the application of evidence-based practice to this condition.
Aim: To determine the prevalence and cause of leg ulceration in a defined geographical population after 8 years of providing standardized evidence based protocols of care.
Design: Prospective survey.
Methods: Patients with leg ulceration of >4 weeks duration) within an integrated acute and community leg ulcer service were ascertained, interviewed and clinically assessed, using a standardized questionnaire on medical history, ulcer details and non-invasive vascular investigation to describe causes. Ulcers were classified by aetiology.
Results: We identified 113 patients in a population of 252 000, giving a crude prevalence of 0.45/1000 (95%CI 0.37–0.54/1000): 0.34/1000 in men, 0.54/1000 in women. Rates were highly dependent on age, increasing to 8.29 (men) and 8.06/1000 (women) in those aged >85 years. Of the responders, 62/113 (55%) had their ulcer for >1 year. Uncomplicated venous ulceration was observed in only 59/138 (43%) ulcerated limbs; a further 21 had ulceration primarily due to arterial disease. Complex causes were present in 48 (35%) limbs, mostly venous disease in combination with diabetes (35%), lymphoedema (42%) and rheumatoid arthritis (26%).
Discussion: Our prevalence of chronic leg ulceration is approximately one-third of that predicted by previous studies using similar methodologies in the 1980s. Patients with ulceration have more complex aetiologies than previously recognized, which may be a consequence of both increasing ulcer chronicity and age.

Item Type: Article
Identifier: 10.1093/qjmed/hch075
Keywords: Leg ulceration; London
Subjects: Medicine and health > Clinical medicine
Depositing User: Rod Pow
Date Deposited: 16 Jul 2012 13:48
Last Modified: 06 Feb 2024 15:39

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