Clinical tool for health professionals

Revised VCSS calculator

The revised Venous Clinical Severity Score grades ten features of chronic venous disease from 0 to 3, giving a score of 0 to 30 for each leg. Unlike CEAP, it changes with treatment, so it is used to document severity and response.

Runs in your browser. Nothing you enter is stored or sent. Decision support only: it does not replace clinical judgement.

Right leg

Pain or other discomfort

Aching, heaviness, fatigue, soreness, burning. Presumes venous origin.

Varicose veins

At least 3 mm in diameter, standing.

Venous oedema

Presumes venous origin.

Skin pigmentation

Excludes focal pigmentation over varicose veins and pigmentation from other chronic disease.

Inflammation

More than recent pigmentation: erythema, cellulitis, venous eczema, dermatitis.

Induration

Chronic oedema with fibrosis, hypodermitis. Includes atrophie blanche and lipodermatosclerosis.

Active ulcers: number
Active ulcer: duration (longest active)
Active ulcer: size (largest active)
Use of compression therapy

Notes on scoring

  • Ask the patient to choose the pain category for each leg separately; examine the veins standing.
  • The three ulcer items score 0 if there is no active ulcer. A healed ulcer scores nothing in the VCSS but is class C5 in CEAP.
  • Compression scores higher with better adherence, so a patient who starts wearing stockings will score higher. Some studies report the score with and without this item.
  • Record CEAP alongside the VCSS: CEAP describes the disease, the VCSS measures its severity. Our CEAP classifier builds the code.

Sources

  1. Vasquez MA, Rabe E, McLafferty RB, et al. Revision of the venous clinical severity score: venous outcomes consensus statement. J Vasc Surg. 2010;52:1387–96.
  2. American Venous Forum. Revised Venous Clinical Severity Score, scoring instructions. 2010.
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