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"American Venous Forum Commitee dari tahun 2000 ndash; 2011 terus mengembangkan sistem skoring penilaian derajat keparahan penyakit vena yang praktis bernama Venous Clinical Severity Score VCSS , namun di Indonesia, instrument VCSS hingga saat ini belum pernah dilakukan validasi. Penelitian ini adalah uji diagnostik skoring VCSS dengan membandingkan pemeriksaan penyakit vena menggunakan skoring VCSS oleh dokter umum dibandingkan dengan pemeriksaan klinis CEAP oleh dokter spesalis vaskuler sebagai baku emasnya. Penelitian dilakukan di perusahaan garmen di Jakarta Utara pada bulan Oktober dengan nilai sensivitas 87,5 , spesifitas 96,3 , nilai duga positif 83,3 dan nilai duga negatif 97,3 . Dari Hasil analisis kurva ROC nilai Area Under the Curve AUC sebesar 94,9 sangat baik. Faktor risiko paling dominan terhadap kejadian IVK pada pekerja wanita dengan posisi kerja berdiri adalah masa kerja lebih dari 1 tahun dengan.

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The American Venous Forum Commitee from 2000 2011 continues to develop a practice scoring system on the severity of venous disease called Venous Clinical Severity Score VCSS , but in Indonesia, this VCSS instrument, until now has never been validated. This study is a VCSS scoring diagnostic test which compere the examination CVI using VCSS by general practitioner and using clinical class of CEAP by vascular specialist as gold standard. Based on the research, the VVTB diagnostic test by using VCSS score was 87.5 sensitivity, 96.3 specificity, 83.3 positive predictive value and 97.3 negative predictive value. From ROC curve analysis, the value of Area Under the Curve AUC is 94.9 which means very good. The most dominant risk factors for the occurrence of CVI in female workers with standing positions were more than 1 year with p "

"Introduction: In 2010, the American Venous Forum developed a Venous Clinical Severity Score (VCSS) scoring system to assess the severity of Chronic Venous Insufficiency (CVI), where this system was said to be more comprehensive than the CEAP system. However, VCSS validation was still lacking. The purpose of this study was to examine VCSS for reflux and leg vein diameter based on ultrasonography. Method: This study was a cross-sectional diagnostic test on women workers with standing work positions of 114 people (228 limbs) in Jakarta. VCSS assessment and ultrasound examinations were carried out on all subjects. The relationship between VCSS with reflux and leg vein diameter was analyzed using an odds ratio with a 95% confidence interval. Results: From 228 examined limbs, the VCSS score of 0-3 was 18.4%, and the score of ≥4 was 81.6%. Reflux was found in 21.9% of the limbs. There was a significant relationship between VCSS and reflux in leg veins. The diameter of the great saphenous vein was between 2.1-12.2 mm, the femoral vein was 7.1-17 mm, the popliteal vein as 3-11.4, and the small saphenous vein was 1.7-7mm. When VCSS was analyzed for association with venous diameter, a significant relationship was found. VCSS sensitivity compared with reflux based on USG was 78%, specificity was 98.31%, positive predictive value was 92.86%, and the negative predictive value was 93.86%.Conclusion: From the results of this study, it was concluded that the VCSS score could be used as a method for assessing chronic venous insufficiency. Although VCSS is was to assess the severity of the chronic venous disease, VCSS can also be used for screening because it shows a good relationship with the reflux and venous diameter of the limbs based on ultrasound."

"Efektifitas EVLA terhadap diameter vena saphena magna yang besar masih banyak diperdebatkan, karena diameter vena saphena magna yang besar memiliki angka oklusi yang lebih rendah pasca EVLA dan diperkirakan mempengaruhi nilai r-VCSS. Desain penelitian ini adalah potong lintang pasien insufiensi vena kronik pada vena saphena magna yang lakukan EVLA di Rumah Sakit Cipto Mangunkusumo dan rumah sakit jejaring dari Juli 2023 – Desember 2023. 37 tungkai dari 34 pasien yang dilakukan EVLA 1470 nm dengan tip radial. Dilakukan pengukuran diameter vena saphena magna dengan usg doppler pada 4 segmen (3 femoral, 1 kruris) dan dibagi berdasarkan nilai potong, dan juga dilakukan penilaian r-VCSS pre EVLA. 1 minggu pasca EVLA dilakukan penilaian oklusi dari vena saphena magna dengan usg doppler dan nilai r-VCSS. Analisis data menggunakan SPSS versi 25.0 secara bivariat dan multivariat. 5 tungkai (13,5%) mengalami gagal oklusi 1 minggu pasca EVLA. Semua kegagalan oklusi pada segmen 1/3 proksimal femoral (diameter >10 mm) (P<0,05). Tidak ada perbedaan bermakna antara angka oklusi dengan nilai r-VCSS, baik pre dan post EVLA (P=0,490 dan P=0,102). Perbedaan diameter sesuai nilai potong tidak mempengaruhi nilai r-VCSS post tindakan. Diameter vena pre-EVLA mempengaruhi keberhasilan oklusi pasca-EVLA. Angka oklusi vena saphena magna tidak mempengaruhi nilai r-VCSS pasca EVLA.

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The effectiveness of EVLA on large saphenous vein diameter is still widely debated, because large saphenous vein diameter has a lower occlusion rate after EVLA and can affect the r-VCSS value. The design of this study was a cross-sectional of patients with chronic venous insufficiency in the great saphenous vein who underwent EVLA at Cipto Mangunkusumo Hospital and a network teaching hospitals from July 2023 – December 2023. 37 extremity from 34 patients underwent 1470 nm EVLA with a radial tip. The diameter of the great saphenous vein was measured using Doppler ultrasound in 4 segments (3 femoral, 1 cruris) and divided based on the cutoff value, and pre-EVLA r-VCSS was also assessed. 1 week after EVLA, the occlusion of the great saphenous vein was assessed using Doppler ultrasound and r-VCSS values. Data analysis used SPSS version 25.0 bivariate and multivariate. cases (13.5%) failed occlusion 1 week post EVLA. All occlusion failure occurred at the 1/3 proximal of the femoral segment (diameter >10 mm) (P<0.05). There was no significant difference between occlusion rates with r-VCSS, pre and post EVLA (P=0.490 and P=0.102). The difference in diameter according to the cut value does not affect the r-VCSS after the procedure. Pre-EVLA vein diameter influences the success of post-EVLA occlusion. The degree of occlusion of the great saphenous vein does not affect the r-VCSS after EVLA."

"Latar Belakang: Dalam diagnosis varises vena tungkai bawah (VVTB), venous clinical severity score (VCSS) merupakan alat bantu diagnosis VVTB yang praktis, cepat, dan dapat dikerjakan oleh semua tenaga kesehatan termasuk perawat. Hingga saat ini belum ada peneliti yang melakukan validasi eksterna penilaian VCSS yang dikerjakan oleh perawat di Indonesia.Tujuan: Mengetahui tingkat ketepatan metode skor VCSS oleh perawat dibandingkan dengan komponen klinis (C) klasifikasi clinical-etiology-anatomy-pathophysiology (CEAP) oleh dokter spesialis bedah vaskular.Metode: Studi cross-sectional ini mengikutsertakan 63 orang perawat instalasi bedah pusat RS Dr. Cipto Mangunkusumo tanpa varises sebelum menjadi perawat sebagai sampel yang diambil secara consecutive Penilaian VCSS dilakukan dengan komponen klinis klasifikasi CEAP sebagai pembanding. Variabel dianalisis dengan uji Chi-square, dilanjutkan dengan uji nilai sensitivitas, spesifisitas, nilai duga positif (NDP), nilai duga negatif (NDN), likelihood ratio dan akurasi skor diagnostik, termasuk analisis uji diagnostik menggunakan indeks Youden.Hasil: Prevalensi VVTB pada studi ini berdasarkan skor VCSS adalah 9,5%. Korelasi antara klasifikasi CEAP dan VCSS ditemukan bermakna (p<0,05). Derajat VVTB antara klasifikasi CEAP dan VCSS berhubungan secara signifikan (p <0,05). Pada cut-offVCSS 2 didapatkan nilai sensitivitas 66,67%, spesifisitas 66,67 %, NDP 32,0%, NDN 89,47%, likelihood ratio (+) sebesar 2,00, likelihood ratio (-) sebesar 0,50, dan akurasi 66,67%.Kesimpulan: Skor VCSS memiliki akurasi lemah terhadap komponen klinis (C) klasifikasi CEAP untuk menegakkan diagnosis VVTB.

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Background: In the diagnosis of lower leg varicose veins (LLVV), the venous clinical severity score (VCSS) is practical, fast, and can be done by all health workers including nurses. Until now there has been no researcher who has conducted external validation of the VCSS assessment carried out by nurses in Indonesia.

Aim: To determine the accuracy of the VCSS scoring method by nurses compared to clinical component (C) of the clinical-etiology-anatomy-pathophysiology (CEAP) classification by vascular surgeons.

Method: This cross-sectional study included 63 nurses at the central surgical installation of Cipto Mangunkusumo Hospital without varicose veins before becoming a nurse as a consecutive sample. The VCSS assessment was carried out with the clinical component of CEAP classification as a comparison. Variables were analyzed by the Chi-square test. Followed by testing the value of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio, and accuracy of diagnostic scores, along with the ROC analysis using Youden Index.

Results and Discussion: The prevalence of LLVV in this study is 9,5%. Bivariate analysis of CEAP and VCSS has a significant correlation (p <0,05). The degree of LLVV with CEAP and VCSS is related significantly (p <0,05). With VCSS cut off at scores of 2, the sensitivity is 66.67%, the specificity is 66.67%, the PPV is 32,0%, the NPV is 89.47%, the positive and negative likelihood ratio are 2.00 and 0.50, and the accuracy value is 66.67%.

Conclusion: The VCSS score has weak level of accuracy against the clinical component (C)  of CEAP classification for diagnosing VVTB."