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

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.