Advertisement

Clinical Impact of Severe Obesity in Patients with Lymphedema

Published:November 16, 2022DOI:https://doi.org/10.1016/j.ejvs.2022.11.014
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Objectives

      With the rate of obesity increasing worldwide we compared Lymphedema (LED) patients with and without concomitant diagnosis of severe obesity (SO), in regard to their baseline demographics, health-related characteristics, treatment plans and patient outcomes.

      Design

      Retrospective observational cohort

      Methods

      The IBM MarketScan Database was examined (2013 - 2019) for patients with a new diagnosis of LED. Of 60 284 LED patients identified 6 588 had Severe Obesity defined by a BMI> 40 kg/m2. The demographics and other characteristics of SO were compared to patients with LED without SO.

      Results

      SO and LED diagnosis increased two-fold from 2013 to 2019. LED SO+ patients were younger (57.8 vs 60.8 years, p <.001), having more men (37.7% vs 24.9%, p <.001) than the LED SO- patients. More comorbidities were observed in LED SO+ compared to LED SO-, (diabetes 46.0% vs. 24.9 % (p <.001), heart failure 18.3% vs. 7.4% (p <.001), hypertension 75.0% vs. 47.6% (p <.001), renal disease 24.8% vs. 11.9% (p <.001). Use of diuretics in the LED SO+ group was greater 57.6% vs. 38.0% (p <.001). LED SO+ patients had higher risk of cellulitis 34.5% vs. 13.5% (p <.001). Specific LED treatment was given more often to LED SO- 66.3% vs. 64.3% (p=.003). This was significant for manual lymphatic drainage 46.6% vs. 40.0% (p <.001) and physical therapy 55.4% vs. 51.6% (p<.001), but not for compression garments 18.2% vs. 17.7% (p=.38). However, more LED SO+ patients received pneumatic compression device treatment 20.9% vs. 13.7% (p <.001).

      Conclusion

      There was an increase in SO associated LED. LED SO+ patients have over a two and half-fold increase in cellulitis incidence, with significant increase in medical resource utilization and cost. Despite this, LED SO patients receive less specific therapy such as compression which has proven to reduce cellulitis incidence.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Vascular and Endovascular Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect