| Pain or other discomfort (ie, aching, heaviness, fatigue, soreness, burning)
|
| 1: Mild |
| Occasional pain or other discomfort (ie, not restricting regular daily activities) |
| 2: Moderate |
| Daily pain or other discomfort (ie, interfering with but not preventing regular daily activities) |
| 3: Severe |
| Daily pain or discomfort (ie, limits most regular daily activities) |
Varicose veins
- "Varicose" veins must be ≥3 mm in diameter to qualify in the standing position
|
| 1: Mild |
Few: scattered (ie, isolated branch varicosities or clusters)
- Also includes corona phlebectatica (ankle flare)
|
| 2: Moderate |
| Confined to calf or thigh |
| 3: Severe |
| Involves calf and thigh |
| Venous edema
|
| 1: Mild |
| Limited to foot and ankle area |
| 2: Moderate |
| Extends above ankle but below knee |
| 3: Severe |
| Extends to knee and above |
Skin pigmentation
- Presumes venous origin
- Does not include focal pigmentation over varicose veins or pigmentation due to other chronic diseases
|
| 0: None |
| None or focal |
| 1: Mild |
| Limited to perimalleolar area |
| 2: Moderate |
| Diffuse over lower third of calf |
| 3: Severe |
| Wider distribution above lower third of calf |
Inflammation
- More than just recent pigmentation (ie, erythema, cellulitis, venous eczema, dermatitis)
|
| 1: Mild |
| Limited to perimalleolar area |
| 2: Moderate |
| Diffuse over lower third of calf |
| 3: Severe |
| Wider distribution above lower third of calf |
Induration
- Presumes venous origin of secondary skin and subcutaneous changes (ie, chronic edema with fibrosis, hypodermitis). Includes white atrophy and lipodermatoselerosis
|
| 1: Mild |
| Limited to perimalleolar area |
| 2: Moderate |
| Diffuse over lower third of calf |
| 3: Severe |
| Wider distribution above lower third of calf |
| Active ulcer number |
| 0: None |
| 0 |
| 1: Mild |
| 1 |
| 2: Moderate |
| 2 |
| 3: Severe |
| ≥3 |
| Active ulcer duration (longest active) |
| 0: None |
| N/A |
| 1: Mild |
| <3 mo |
| 2: Moderate |
| >3 mo but <1 y |
| 3: Severe |
| Not healed for >1 y |
| Active ulcer size (largest active) |
| 0: None |
| N/A |
| 1: Mild |
| Diameter <2 cm |
| 2: Moderate |
| Diameter 2-6 cm |
| 3: Severe |
| Diameter >6 cm |
| Use of compression therapy |
| 0: None |
0
Not used |
| 1: Mild |
1
Intermittent use of stockings |
| 2: Moderate |
2
Wears stockings most days |
| 3: Severe |
3
Full compliance: stockings |
Modified from Vasquez MA, Rabe E, McLafferty RB, Shortell CK, Marston WA, Gillespie D, et al. Revision of the venous clinical severity score: Venous outcomes consensus statement: Special communication of the American Venous Forum Ad Hoc Outcomes Working Group. J Vasc Surg 2010;52:1387-96.