Abstract: The aims of the study were to describe and analyse the temporal trend of the prevalence
and incidence of venous leg ulcers (VLU) over the years 2010 to 2014, to
determine healing times and temporal trends in the study period, and to evaluate
related aspects such as the use of the Ankle-Brachial Pressure Index (ABPI) in a
primary care health centre. This was a retrospective study based on a time series
(years 2010-2014) of the prevalence and incidence of VLUs in people aged over
40 years in a primary care centre in Barcelona City. We reviewed 3920 electronic
health records selecting patients, per year (2010-2014), with VLUs based on the
ICD-10 diagnoses. For prevalence, we took into account any patient with an active
VLU in the year of study. For incidence, we took into account patients with a new
VLU in the year of study. A descriptive analysis was carried out based on each of
the collected variables. The variables were examined according to the years of
study (time series) by one-factor analysis of variance (ANOVA) or Kruskal?Wallis
non-parametric test, as appropriate. A survival analysis by Kaplan?Meier curves
and log-rank test was also performed. A total of 139 patients met the VLU criteria.
Among them, only 79.2% were classified as having a VLU and had a correct ICD
diagnosis. The prevalence and incidence increased over the years, doubling in
patients aged over 65 years. Incidence increased from 0.5 new cases per 1000 people/
year in 2010 to 1 new case for every 1000 people/year in 2014. Moreover, the
prevalence ranged between 0.8 and 2.2 patients with VLU for every 1000 people/
year. During the study period, a total of 84.2% of the VLUs healed (117/139
VLU). Regarding average annual time to healing, the trend indicates that lesions
took less time to heal (Kruskal?Wallis test, P = 0.004), ranging between
453,9 weeks in 2005 to 19 weeks in 2014. The use of ABPI also evolved and was
found to be increasingly performed prior to the appearance of the lesion. The epidemiological
profile of people affected by VLUs continues to be, mainly, that of
women of an advanced age, over 70 years. The frequency of VLU occurrence rose
continually over the years, but healing took less time, and use of ABPI improved.
Assigning a reference nurse in the wounds unit and the organisational structure
around this problem may have an influence on improving care and the approach to
these types of lesions.
