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

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.

Developing the Role of the Clinical Academic Nurse, Midwife and Allied Health Professional in Healthcare Organisations

“…In Nottingham, significant strides are being made in understanding and improving the experience of children and young people with mental health conditions and their families under the leadership of a postdoctoral NIHR Clinical Lecturer and jointly appointed professor (Carter et al, 2019;Manning et al, 2018). Similarly, the care and experiences of adults and children with Chronic Lymphedema are being transformed under the leadership of an internationally renowned Clinical Professor and local PhD clinical academics and specialist teams (Quéré et al, 2019), with strategic ambitions to transform services at NUH and across the wider community of Nottinghamshire.…”

Lower limb chronic edema management program: Perspectives of disengaged patients on challenges, enablers and barriers to program attendance and adherence

“…Obesity is not necessarily unique to this cohort, as it has estimated that 63.4 per cent of Australian adults are considered overweight [58]. There is growing evidence that being obese is a significant risk factor for CO [15, 59, 60] however it was infrequently highlighted by the study cohort.…”

“…Accordingly, a previous study reported a CO prevalence rate of 28.5 percent amongst hospital inpatients [11]. According to the most recent and largest epidemiology international study on CO, the ‘Lymphedema IMpact and PRevalence INTernational’ (LIMPRINT), that involved collaboration across nine countries and 13,141 participants, there was a higher prevalence rate of 38% (723 patients) amongst acute hospital inpatients [14, 15]. Significant risk factors associated with CO were reported to be advancing age, obesity, immobility and comorbidities including diabetes mellitus [15].…”

“…According to the most recent and largest epidemiology international study on CO, the ‘Lymphedema IMpact and PRevalence INTernational’ (LIMPRINT), that involved collaboration across nine countries and 13,141 participants, there was a higher prevalence rate of 38% (723 patients) amongst acute hospital inpatients [14, 15]. Significant risk factors associated with CO were reported to be advancing age, obesity, immobility and comorbidities including diabetes mellitus [15]. One of the complications of CO involves sustaining wounds commonly in the lower limb impacting on the individual’s mobility [15, 16].…”

“…Significant risk factors associated with CO were reported to be advancing age, obesity, immobility and comorbidities including diabetes mellitus [15]. One of the complications of CO involves sustaining wounds commonly in the lower limb impacting on the individual’s mobility [15, 16]. Chronic edema was significantly associated with a history of cellulitis [15], namely that patients with and without wounds suffered at least one event of cellulitis compared to those without CO.…”