Article

In the United States, there are more than 100.000 people with spina
bifida. There have been very few studies to date documenting the occurrence of
lymphedema in the spina bifida population, despite a case series in 2001 that
suggested that the occurrence may be higher than in the general population.
Currently, approximately 1 million people have lymphedema in the United States.
The purpose of this study was to document the occurrence of lymphedema and
associated medical factors in a regional adult spina bifida population. DESIGN: A
total of 240 electronic medical records from the Adult Spina Bifida Clinic from
January 2005 to August 2008 were retrospectively reviewed. Subjects were divided
into two groups based on the presence or absence of lymphedema. chi(2) analyses
were used to compare lymphedema groups with respect to history of medical
comorbidities and ethnicity. Fisher exact tests were used to compare groups with
respect to mobility status and the presence of power wheelchair seat functions.
Mann-Whitney U tests were used to compare groups with respect to age, anatomic
lesion level, employment level, and income. RESULTS:
Twenty-two (9.2%) patients
had lymphedema. Mean +/- SD population age was 35.1 +/- 11.1 yrs. Lymphedema was
associated with a history of trauma (P = 0.044), cellulitis (P < 0.001), cancer
(P = 0.038), obesity (P < 0.001), wounds (P < 0.001), hypertension (P = 0.036),
higher lesion level spina bifida (P = 0.049), and mobility status (P = 0.007).
Hypertension and obesity were present in 38.3% and 37.5% of the total study
population, respectively. CONCLUSIONS: This is the first study to document the
occurrence of lymphedema in a spina bifida patient population, which was almost
100 times higher than that in the general patient population. We also documented
a high occurrence of hypertension and obesity in the total study population.
These findings may help guide further prospective studies to more clearly
delineate the risk factors for the development of lymphedema and to determine the
appropriate therapies. Better screening, prevention and treatment algorithms are
needed for hypertension and obesity in the spina bifida population.

Langue : ANGLAIS