LIMPRINT: Estimation of the Prevalence of Lymphoedema/Chronic Oedema in Acute Hospital in In-Patients.

Isabelle Quéré,Vaughan Keeley,Susan Nøerregaard,Sylvie Palmier,Martina Sykorova,Jenica Pastor,Tonny Karlsmark,Gregoire Mercier,Peter J Franks,Sandrine Mestre,Susie Murray,Norah Kyne,Susan Bermark,Mary-Paula Colgan,Eleanor Dring,Christine J Moffatt,Marie-Michelle Coulombe

doi:10.1089/lrb.2019.0024

Abstract

Background: To estimate the prevalence of lymphedema/chronic edema (CO) and wounds in acute hospital inpatients in five different countries.Methods and Results: A point-prevalence study was carried out during working day periods in six general hospitals in four countries (Denmark, France, United Kingdom, and Australia) and one hospital oncology inpatient unit in one other country (Ireland). The study used validated clinical tools for the assessment and collection of data. Data were collected by expert clinicians through interviews and physical examination of the patients present in the wards. A total of 1905 patients could be included and investigated among the 3041 total bed occupancy in the seven hospitals. Lymphedema/CO was present in 723 of them (38%). Main risk factors associated with CO were age, morbid obesity, and heart failure, as well as chair bound immobility and neurological deficiency. History of cellulitis was frequent in patients with CO and wounds (24.8%) and CO alone (14.1%) compared to the 1.5% prevalence in patients without CO.Conclusion: Lymphedema/CO is very frequent in patients hospitalized in hospital acute wards. It is strongly associated with obesity, venous insufficiency, and heart failure. Our results strongly suggest a hidden health care burden and cost linked to CO independently of chronic wounds.

Highlights

To estimate the prevalence of lymphedema/chronic edema (CO) and wounds in acute hospital inpatients in five different countries
The different hospitals participating in the study were two teaching hospitals in Nottingham (Queen’s Medical Centre [QMC]), Nottingham City Hospital (City), United Kingdom; four teaching hospitals Saint Eloi, Gui de Chauliac, Lapeyronie, and Arnaud de Villeneuve in Montpellier, France; two hospitals in Copenhagen, Denmark (Bispebjerg and Frederiksberg Hospital); one general hospital in Canberra, Australia (Calvary Public Hospital Bruce); and one inpatient oncology ward in Galway, Ireland (University Hospital Galway)
Lymphedema/CO is a chronic swelling condition that contributes to disability, chronic wounds, and lost quality of life

Summary

Introduction

To estimate the prevalence of lymphedema/chronic edema (CO) and wounds in acute hospital inpatients in five different countries. Conclusion: Lymphedema/CO is very frequent in patients hospitalized in hospital acute wards It is strongly associated with obesity, venous insufficiency, and heart failure. Epidemiology studies in lymphedema have frequently focused on single patient populations such as those with cancer rather than on assessing the heterogeneous population that may suffer with the condition.[1] A public health definition of chronic edema (CO) has been developed and used over the last decades and this reflects the complex pattern of patients who may present with the problem.[2] The definition defined below has been adopted in the LIMPRINT study:. The concept that CO may be a predictor of frailty as well as being a risk factor for complications such as cellulitis and wounds is worthy of further investigation

Objectives

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Conclusion