Multivariate Regression Analysis of Risk Factors for Lower Extremity Varicose Veins Based on VCSS Scores

Abstract Objective This study aimed to compare the characteristics of risk factors for lower limb varicose veins (VV) and identify key variables associated with disease severity to guide clinical prevention and management strategies. Methods A cross-sectional study was conducted on 751 patients with primary lower limb varicose veins admitted to the Affiliated Hospital of Xuzhou Medical University between June 2024 and June 2025. Clinical data were collected, and disease severity was assessed using the Venous Clinical Severity Score (VCSS). A Generalized Additive Model (GAM) was applied to analyze the association between VCSS scores and various risk factors, including age, gender, BMI, family history, hypertension, diabetes, smoking, alcohol consumption, behavioral factors, and venous valve dysfunction. Residual analysis was performed to assess model fit. Results Age, gender, BMI, family history, hypertension, diabetes, smoking, alcohol use, behavioral factors, and valve dysfunction were all significantly associated with VCSS scores (all P < 0.05). Female patients showed a slightly higher prevalence than males. Patients who smoked (β = 1.14) or consumed alcohol (β = 1.47) had higher VCSS scores. Obesity was also a major aggravating factor. Chronic diseases such as hypertension (β = 1.45) and diabetes (β = 1.20) increased the disease burden. Valve dysfunction (β = 1.50) had a considerable impact on VCSS scores. The strongest associations were observed for family history (β = 3.13) and behavioral factors (β = 2.04), highlighting the importance of early behavioral intervention and genetic risk management. Conclusions The severity of primary lower limb varicose veins is influenced by a range of risk factors. Clinical management strategies should take these into account, with targeted interventions. For instance, patients with behavioral risk factors may benefit from early use of compression stockings to prevent venous edema, while those with high BMI or a history of smoking should be advised to adopt weight reduction and smoking cessation programs promptly.