Evaluation of the relationship of the severity of lymphoedema with the number of co-existing medical conditions and frequency of cellulitis in cancer and non-cancer related lymphoedema: a service evaluation.

Abstract

Question: What is the relationship between the severity of lymphoedema with the number of medical conditions present and the frequency of cellulitis in patients with cancer and non-cancer related lymphoedema? Design: This research was undertaken as a service evaluation for the Lothian lymphoedema service. Participants: 258 patients with a recorded level of severity were included from the Lothian lymphoedema service. 26 patients without a recorded frequency of cellulitis were then excluded from the severity of lymphoedema and frequency of cellulitis analysis only. Patients with a recorded active cancer or history of cancer were included in the cancer group while those without were grouped into the non-cancer group. Results: A weak link between an increased severity of lymphoedema with an increased number of medical conditions was observed in both the cancer (p=0.003; τ=0.330) and non-cancer (p=0.03; τ=0.129) groups. No relationship between the severity of lymphoedema and frequency of cellulitis was found in the cancer (p=0.202; τ =0.221) and non-cancer (p=0.108; τ=0.064) groups. A number of factors influenced the validity of these results. Conclusion: Patients with a higher number of co-existing medical conditions are at a higher risk of developing a more severe lymphoedema in both patient with cancer and non-cancer related lymphoedema. The severity of lymphoedema has not been shown to influence the frequency of cellulitis therefore all patient with lymphoedema should be adequately educated about cellulitis.