Factors Determining Seasonal Variations in Varicose Vein Surgery

Varicose vein operations are traditionally performed during the winter season because of supposed advantages during post-operative care. This prospective study aimed to investigate how, and on what grounds, patients and physicians time varicose vein surgery.

Unselected patients attending a consultation for varicose vein surgery at a Regional Hospital in Thun, Switzerland were asked to fill out an anonymous and standardised questionnaire to register the C of CEAP, age, and gender and to understand the drivers behind the timing of the actual intervention. The five main criteria were: job, workplace; symptoms, prevention; family, leisure, sports; season; and other.

Between May 2015 and April 2017 (a 24 month period spanning two full seasonal cycles) 153 consecutive patients were included and returned 153 questionnaires for analysis. The actual timing of varicose vein surgery correlated inversely with the average temperatures measured in Thun. Among men (n = 65, 43% of the study population), job requirements were the most frequent determinant (41% of cases) of the operating day. Among women, by contrast, symptoms and prevention were named most often (32% of cases) as the leading motivation for surgical timing. Although for both men and women job and workplace was a leading factor over all CEAP classes (28.6%), the importance of symptoms and prevention increased with the CEAP class: from 26.3% in classes 2-4 to 51.8% in classes 5-6.

Although inversely correlated with outside temperature, the concentration of varicose vein surgery to the winter months seems to be coincidental. The patient's job situation represents overall the most important determinant of surgical planning. Symptoms and prevention are more important in certain subgroups than in others, that is among women and among patients with high CEAP classes.