PB0449 - Impact of self-reported race on Villalta Scale scores and correlation with venous disease specific quality of life: an exploratory analysis of the ATTRACT Trial

Background: The Villalta Scale (VS) to diagnose post-thrombotic syndrome (PTS) consists of 5 patient-reported leg symptoms and 6 clinician-rated leg signs. It is unknown how the scale performs across ethnoracial groups.

Aims: Our study explored if there were differences in scoring of the VS, particularly clinician-rated signs components, according to self-reported race.

Methods: Exploratory analysis of the ATTRACT trial, a RCT conducted at 56 U.S. sites that investigated pharmacomechanical catheter-directed thrombolysis to prevent PTS after proximal DVT. Among self-reported Black (n=123) and White (n=541) participants, we compared, at the 6 month visit, mean total VS score, VS symptoms score, VS signs score, individual signs scores, and correlation coefficients between VS signs and VS symptoms scores, and between VS signs and VEINES-QOL scores (self-reported venous disease-specific quality of life measure).

Results: At 6 months, mean total VS score (4.67 vs. 4.12, p=0.30) and VS signs score (1.66 vs 2.00, p=0.21) were similar in Black vs. White participants. Clinicians more frequently rated the sign venous ectasia as absent in Black vs. White participants (83% vs 56%; p< 0.001). Mean VS symptoms score was higher in Black vs. White participants (2.83 vs 2.04, p= 0.04). There was similar, modest correlation in Black and White participants between VS signs and VS symptoms scores (r=0.25; r=0.25), and between VS signs and VEINES-QOL scores (r= -0.34; r= -0.29). Results were similar after adjustment for baseline variables age, sex, BMI, DVT extent, hypertension, diabetes, dyslipidemia and congestive heart failure.

Conclusion(s): Findings suggest that some differences in VS scores exist according to self-reported race. It is unclear whether these reflect clinician underrating of some VS signs and/or differences in PTS severity. Further work is needed to understand how the VS performs across ethnoracial groups.