Clinical characteristics associated with pain in patients with peripheral Vascular Malformations.

OBJECTIVE Vascular malformations can negatively impact the patient's quality of life. Pain is a common problem in these patients. The aim of this study was to investigate risk factors associated with pain and to assess how pain affects quality of life. METHODS This prospective cross-sectional study was conducted in a tertiary vascular anomaly expertise center. Between June and December 2020, all patients from our local database (334 adults and 189 children) with peripheral vascular malformations were invited to complete the Outcome Measures for VAscular MAlformations (OVAMA) questionnaire to evaluate the presence, frequency, and intensity of pain. Additionally, patients were asked to complete several Patient-Reported Outcome Measurement Information System (PROMIS) scales to evaluate their quality of life. Risk factors associated with pain were identified in bivariate analysis and multivariable logistic regression. Quality of life domains were compared between patients who experienced pain and patients who did not. RESULTS A total of 164 patients completed the questionnaire about pain and 133 patients completed all quality of life questionnaires. Approximately half of the patients (52%) reported pain in the past four weeks and 57% of these patients reported pain daily or several times a week. Female gender (p=0.009), lesions located in the upper extremity (p<0.001) or lower extremity (p<0.001), and intramuscular/intraosseous lesions (p=0.004) were independently associated with the presence of pain. The following quality of life domains were diminished in patients who experienced pain in comparison to patients who did not: pain interference (p<0.001), physical functioning (p<0.001), and social participation (p<0.001) in adults, and pain interference (p=0.001), mobility (p=0.001), and anxiety (p=0.024) in children. CONCLUSION Pain is a frequently reported complaint in patients with vascular malformations and is present in approximately half of the patients. Patients with lesions located in the upper or lower extremity, intramuscular/intraosseous lesions, and female patients are more likely to experience pain. The presence of pain negatively impacted patients' quality of life. Although VM are a benign condition and expectative management is frequently applied, our study shows that pain is a serious concern and needs to be actively assessed. Pain is a sign of various etiologies, which should be examined in order to properly treat the pain.