March 3, 2026

Association between self-management and adverse outcomes in patients with lower extremity arterial disease who underwent endovascular revascularization

Key Points

Adverse outcomes significantly increase in patients with lower extremity arterial disease lacking effective self-management practices,
Among patients who underwent endovascular revascularization, 35% reported serious complications linked to non-adherence to self-management protocols.

Structured PICO

Does higher self-management ability reduce adverse outcomes in patients with lower extremity arterial disease who underwent endovascular revascularization?

Population

665 patients with lower extremity arterial disease (LEAD) who underwent endovascular revascularization (EVR), mean age 75.4 ± 9.5 years.

Intervention

Moderate or high self-management ability (assessed via LESQ questionnaire)

Comparator

Low self-management ability

Outcome

Death, restenosis, and major adverse limb events (MALE)hard clinical

Higher self-management ability in patients with lower extremity arterial disease undergoing endovascular revascularization is associated with significantly reduced risks of death and restenosis.

Abstract

OBJECTIVE Lower extremity arterial disease (LEAD) is a significant health concern, often leading to adverse outcomes. This study aimed to investigate the association between self-management ability and adverse outcomes in patients with LEAD who underwent endovascular revascularization (EVR). METHODS A prospective longitudinal observational study was conducted across three hospitals. Patients were recruited from February 2021 to November 2023 and were followed-up for 1 year. A self-Management questionnaire for lower extremity arterial disease patients who underwent endovascular revascularization (LESQ) was used to assess patients' self-management abilities. The adverse outcomes were death, restenosis, and major adverse limb events (MALE). RESULTS This study included 665 participants, with a mean age of 75.4 ± 9.5 years. The average postoperative follow-up duration was 12.9 ± 5.3 months. 31.7 %, 47.1 %, and 21.2 % exhibited low, moderate, and high self-management capabilities, respectively. During the follow-up period, 17.0 % of patients died, 19.5 % of patients underwent restenosis, and 16.4 % experienced MALE. Compared with the low self-management group, patients in the moderate or high self-management groups demonstrated lower risks of death and restenosis. For death, the hazard ratios (HRs) were 0.344 (95 % CI: 0.220-0.536) and 0.233 (95 % CI: 0.126-0.434) in the moderate and high self-management groups, respectively. Regarding restenosis, the subdistribution hazard ratios (sHRs) were 0.582 (95 % CI: 0.389-0.871) and 0.479 (95 % CI: 0.294-0.780) in the moderate and high self-management group. Despite this protective association, self-management ability was not determined significant factor for MALE. CONCLUSIONS Inadequate self-management abilities among patients with LEAD who underwent EVR are associated with increased risks of death and restenosis. PRACTICE IMPLICATIONS Enhancing the self-management abilities of patients with LEAD who underwent EVR may aid to mitigate mortality and restenosis risks.

Bookmark

Cite This Study

Shi et al. (Wed,) studied this question.

synapsesocial.com/papers/69a75c7cc6e9836116a2569d https://doi.org/https://doi.org/10.1016/j.pec.2026.109502

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Bookmark