The Ulcerated Leg Severity Assessment score for prediction of venous leg ulcer healing

Br J Surg. 2007 Feb;94(2):189-93. doi: 10.1002/bjs.5597.


Background: The aim of the study was to create a reliable scoring system for the prediction of venous ulcer healing in patients treated with compression.

Methods: A prospective baseline study to identify risk factors for venous ulcer healing was undertaken between March 1999 and August 2001. All patients were treated with multilayer compression. A number of variables were related to 24-week healing rates. A Cox regression model was used to identify risk factors that predicted ulcer healing, from which a scoring system was developed and validated prospectively between February 2004 and March 2005.

Results: In the baseline study of 229 patients, patient age, ulcer chronicity and venous refill time (VRT) of 20 s or less were identified as risk factors. Using these factors and hazard ratios from the Cox regression analysis, the following formula was devised: Ulcerated Leg Severity Assessment (ULSA) score=age+chronicity-50 (when VRT is greater than 20 s). Patients with an ULSA score of 50 or less had higher 24-week ulcer healing rates than those with higher scores in both the baseline study (P<0.001, log rank test) and the validation study performed in 86 patients (P=0.007, log rank test).

Conclusion: The ULSA score may help to identify patients with venous ulcers unlikely to respond to conventional treatment who could be offered alternative therapy.

Publication types

  • Randomized Controlled Trial
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Regression Analysis
  • Risk Factors
  • Severity of Illness Index*
  • Stockings, Compression*
  • Varicose Ulcer / therapy*
  • Wound Healing / physiology*