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Page 4 of 6 Kaima et al. Vessel Plus 2020;4:37 I http://dx.doi.org/10.20517/2574-1209.2020.50

Figure 1. Frequency and percentage of clinical CEAP intensity in nurses. CEAP: Comprehensive Classification System for Chronic Venous
Disorders

Table 2. Clinical CEAP classification and CIVIQ comparison between non-OR nurses and OR nurses
Total n = 222 Non-OR nurses n = 123 OR nurses n = 99 P-value
CEAP, n (%) < 0.001*
C0 46 (20.8) 14 (11.5) 32 (32.3)
C1 147 (66.5) 88 (72.1) 59 (59.6)
C2 28 (12.7) 20 (16.4) 8 (8.1)
CIVIQ 0.962
Mean ± SD 85.69 ± 12.04 85.75 ± 11.91 85.60 ± 12.24
Median (min-max) 89 (30-100) 89 (43-100) 88 (30-100)

N: number; CEAP: Comprehensive Classification System for Chronic Venous Disorders; CIVIQ: Chronic Venous Insufficiency Quality of
Life Questionnaire-14. *P value < 0.05 was considered statistically significant

Other risk factors of chronic venous disease such as older age, female gender, obesity, and family history
of varicose veins are not different between the groups. The height of the OR nurses is greater than non-OR
nurses and have statistical significance, but perhaps the difference around two centimeters might not have
any clinical relevance. In short, we found that non-OR nurses had more prevalence of CVD, although our
study did not show risk factor differences. The reason behind this difference is not clear. Further cohort
study is needed to continue for more specific and further study risk factors. This can help nurses improve
both their physical and mental health.

There were limitations in this study. The OR nurse group has a greater frequency of younger nurses (double
frequency in the below 35 group) than those in non-OR nurse group. Also, there were more males in OR
nurse group than those in non-OR group. As is well known, the prevalence of CVD is age and gender
dependent. These might be a bias of this study. There are a large number of risk factors that can determine
the progression in CVD including weight, body mass index, number of pregnancy, career, and family
history of chronic venous disease. Therefore, our findings need to be confirmed in a large population with
adjusting confounders (multivariate analysis). Additionally, this study was a cross sectional study, so it
cannot explain cause and effect.

CVD has a substantial effect on the quality of life, especially physical health aspects [12,13] . The mental health
[14]
aspect is affected only in a severe stage (C3 or more) . Our study shows non-OR nurses had more CVD (C1
and C2), but the quality of life was not remarkably different (P = 0.962).