Prediction of Health Status in Patients Undergoing Lower Extremity Intervention for Claudication

Area of Science:

• Vascular Surgery
• Health Outcomes Research
• Medical Informatics

Background:

• Predicting health status after femoral-popliteal peripheral vascular intervention (PVI) for claudication is understudied.
• Identifying predictors is crucial for risk-based therapeutic approaches to improve patient outcomes in peripheral artery disease (PAD).

Purpose of the Study:

• To identify key predictors of generic and disease-specific health status outcomes one year after PVI for claudication.
• To establish a foundation for risk-stratified management strategies in PAD patients undergoing PVI.

Main Methods:

• A cohort of 468 patients with claudication undergoing PVI (drug-coated or plain balloon angioplasty) from 2013-2019 was analyzed.
• 59 baseline variables were assessed to predict 1-year generic (EQ-5D-3L, EQ-5D VAS) and disease-specific (WIQ) health status.
• A random forest model was employed to rank variable importance for predicting health status outcomes.

Main Results:

• The most significant predictors for EQ-5D-3L were a history of deep venous thrombosis.
• Chronic lung disease was the primary predictor for EQ-5D VAS.
• Hypertension emerged as the key predictor for the Walking Impairment Questionnaire (WIQ).

Conclusions:

• Comorbidities are the most critical predictors of future health status in patients undergoing PVI for claudication.
• An integrated management approach is essential for peripheral artery disease.
• Machine learning facilitates the development of predictive models for risk-based treatment decisions.