The Venous Clinical Severity Score (VCSS) was developed to evaluate the severity of venous disease involving the lower extremity. It can be used to monitor disease progression and response to therapeutic interventions. It is intended to replace the clinical score of the CEAP (above).
Parameters:
(1) pain
(2) varicose veins
(3) venous edema
(4) skin pigmentation
(5) inflammation
(6) induration
(7) total number of ulcers (both active and healed)
(8) duration of active ulceration
(9) size of active ulcer
(10) compressive therapy
|
General Scoring Scheme |
Points |
|
absent |
0 |
|
mild |
1 |
|
moderate |
2 |
|
severe |
3 |
|
Parameter |
Finding |
Points |
|
pain |
none |
0 |
|
|
occasional, not restricting activity or requiring analgesics |
1 |
|
|
daily, moderate limitation in activity, occasional analgesics |
2 |
|
|
daily, severely limits activities, regular use of analgesics |
3 |
|
varicose veins |
none |
0 |
|
|
few scattered; branch varicose veins with competent greater and lesser saphenous veins |
1 |
|
|
multiple; single segment greater/lesser saphenous vein reflux |
2 |
|
|
extensive; multi-segment greater/lesser saphenous vein reflux |
3 |
|
venous edema |
none |
0 |
|
|
evening ankle edema only |
1 |
|
|
afternoon edema above ankle |
2 |
|
|
morning edema above ankle requiring active change, elevation |
3 |
|
skin pigmentation |
none |
0 |
|
|
focal, low intensity (tan) |
0 |
|
|
diffuse, but limited in area and old pigmentation (brown) |
1 |
|
|
diffuse over gaiter distribution (lower third), or recent pigmentation (purple) |
2 |
|
|
wider distribution (above lower third) and recent pigmentation (purple) |
3 |
|
inflammation |
none |
0 |
|
|
mild cellulitis (limited or marginal area around ulcer) |
1 |
|
|
moderate cellulitis (involves most of gaiter area) |
2 |
|
|
severe cellulitis (lower third or above) |
3 |
|
|
venous eczema |
3 |
|
induration of lower extremity |
none |
0 |
|
|
focal, circum-areolar, < 5 cm |
1 |
|
|
medial or lateral, less than lower third |
2 |
|
|
entire lower third or more |
3 |
|
total number of ulcers |
0 |
0 |
|
|
1 |
1 |
|
|
2 to 4 |
2 |
|
|
>= 5 |
3 |
|
duration of active ulceration |
none |
0 |
|
|
< 3 months |
1 |
|
|
3 to 12 months (> 3 months and < 1 year) |
2 |
|
|
not healed in > 1 year |
3 |
|
active ulcer size |
none |
0 |
|
|
< 2 cm in diameter |
1 |
|
|
2 to 4 cm in diameter |
2 |
|
|
> 4 cm in diameter |
3 |
|
compressive therapy |
not used |
0 |
|
|
not compliant |
0 |
|
|
intermittent use of stockings |
1& Specialty: Cardiology ICD-10: , |
