Journal «Angiology and Vascular Surgery» • 

2005 • VOLUME 11 • №2

THE LOSS OF WORK FITNESS AND THE COURSE OF INVALIDISM IN PATIENTS WITH LIMB VESSEL LESIONS

V.F. Chernenko, A.G. Goncharenko, A.Yu. Shuvalov,V.V. Chernenko, I.V. Tarasov
Chair of Hospital Surgery, Altai State Medical University,
Head Bureau of Medicosocial Expert Evaluation.City Hospital №3,
Barnaul, Russia

The growth of the sick rate of limb peripheral vessels associated with a severe outcome (trophic ulcers, amputation) exerts an appreciable effect on the lowering of quality of life in patients. This manifests by the prolonged loss of work fitness, change of the habitual occupation and disability establishment. Objective analytical information on this problem will be of help in the delineation of the tendencies in this direction and potential approaches to the prevention of social losses.The present work is based on an analysis of 2115 statements of medicosocial expert evaluation (MSEE) of invalids suffering from diseases of limb vessels, performed over recent 8 years in the Altai region. The decisions made by the MSEE were based on the results of the clinical examination of patients using the current diagnostic modalities (ultrasonography, duplex scanning, angiography, etc). It has been established that among persons who had undergone MSEE, over the half (64.1%) were under 60 years, i.e. in the age of work fitness. It is noteworthy that the overwhelming number of invalids were men (83%) and workers (84.2%). As for special vascular pathologies, the majority of patients presented with obliterative arteriai diseases (OAD) of the lower limbs, accounting for 76.3% whereas patients with venous pathology ranked second in number (15.9%). The highest severity of invalidism (groups I and II) was also recorded in OAD (77.5%), especially in atherosclerosis obliterans (AO) which accounted for 84%. Of note, these diseases were marked by no tendency toward reduction of their incidence. The time of temporary disability (from 3 to 9 months) was also most frequently recorded in OAD of the limbs. In OAD, the temporary or persistent loss of work fitness were caused by critical ischemia and amputations whereas in venous pathology, namely in varicosity and postthrombophlebitic syndrome, the cause was progressing CVI complicated by trophic ulcers. On the whole, the lack of changes in the lowering of the number of invalids due to the given pathology evidences the unsatisfactory results of these patients' rehabilitation and the high socioeconomic tension determined by considerable treatment expenses and the high number of the disabled. Approaches to the escape from such a situation should be looked for in the early mass screening diagnosis of vascular lesions, early drug and surgical treatment and in the refinement of the system of rehabilitation prophylactic medical examination.

KEY WORDS: disability, medicosocial expert evaluation, loss of work fitness, obliterative arterial diseases, limb venous diseases, rehabilitation prophylactic medical examination.

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