Tesis

Hubungan Venous Cliniical Severity Score dengan Refluks dan Diameter Vena Tungkai Berdasarkan Ultrasonografi Pada Pekerja Wanita dengan Faktor Risiko = Relationship between Venous Clinical Severity Score with Reflux and Leg Vein Diameter Based on Ultrasonography in Female Workers with Risk Factors.

Pada tahun 2010 American Venous Forum mengembangkan sebuah sistem skoring Venous Clinical Severity Score (VCSS) untuk menilai tingkat keparahan Insufisiensi Vena Kronik, dimana system ini dikatakan lebih lengkap daripada system CEAP. Tetapi validasi VCSS terhadap uji obyektif masih kurang. Tujuan Penelitian ini adalah untuk menguji VCSS terhadap refluks dan diameter vena tungkai berdasarkan ultrasonografi. Penelitian ini merupakan suatu uji diagnostik potong lintang pada pekerja wanita dengan posisi kerja berdiri sebnyak 114 orang (228 tungkai). Dilakukan penilaian VCSS dan pemeriksaan USG pada semua subjek. Hubungan antara VCSS dengan refluks dan diameter vena tungkai dianalisis menggunakan odd rasio dengan interval kepercayaan 95%. Dari 228 tungkai yang diperiksa didapatkan skor VCSS 0-3 sebanyak 18,4%, skor ≥4sebanyak 81,6%. Refluks didapatkan pada 21,9% tungkai. Terdapat hubungan yang signifikan antara VCSS dengan refluks pada vena tungkai. Sedangkan diameter vena safena magna antara 2,1-12,2mm, vena femoral 7,1-17mm, vena popliteal 3-11,4 dan vena safena parva 1,7-7mm. Ketika VCSS dihubungkan dengan diameter vena, didapatkan hubungan yang signifikan. Sensistivitas VCSS dibandingkan dengan refluks berdasarkan USG didapatkan 78%, spesivitas 98,31%, nilai prediksi positif 92,86% dan nilai prediksi negatif 93,86%. Dari hasil penelitian ini disimpulkan skoring VCSS dapat dipakai sebagi metode untuk menilai insufisiensi vena kronik. Meskipun VCSS dirancang untuk menilai keparahan penyakit vena kronis, VCSS dapat juga dipaki untuk melakukan skrining karena menujukkan hubungan yang baik dengan refluks dan diameter vena tungkai berdasarkan USG.
Kata kunci: VCSS, IVK, Ultrasonografi


In 2010 the American Venous Forum developed a scoring system for the Venous Clinical Severity Score (VCSS) to assess the severity of chronic venous insufficiency, where the system is said to be more complete than the CEAP system. But the VCSS validation of the objective test is still lacking. The aim of this study was to test VCSS for reflux and diameter of leg veins based on ultrasonography. This study is a cross-sectional diagnostic test on female workers with a working position standing at 114 people (228 limbs). VCSS assessment and ultrasound examination were performed on all subjects. The relationship between VCSS and reflux and limb vein diameter was analyzed using odds ratios with a 95% confidence interval. From the 228 limbs examined, the VCSS score of 0-3 was 18.4%, the score ≥4 was 81.6%. Reflux is obtained at 21.9% of the legs. There is a significant relationship between VCSS and reflux in the leg veins. Whereas the diameter of the safena magna vein is between 2.1-12.2mm, 7.1-17mm femoral vein, popliteal vein 3-11.4 and safena parva vein 1.7-7mm. When VCSS is associated with vein diameter, a significant relationship is obtained. The sensitivity of VCSS compared with reflux based on USG was 78%, the specificity was 98.31%, the positive predictive value was 92.86% and the negative predictive value was 93.86%. From the results of this study concluded VCSS scoring can be used as a method to assess chronic venous insufficiency. Although VCSS is designed to assess the severity of chronic venous disease, VCSS can also be cited for screening because it shows a good relationship with reflux and diameter of leg veins based on ultrasound.
Key words: VCSS, CVI, Ultrasound