Factors Associated With Venous Leg Ulcer Recurrence and Recurrence Risk in Portugal: A Cross-Sectional Study...

Venous ulcers are the most common lower-limb lesions (60%-80%), affecting about 0.3% of the population. Their chronic nature leads to high recurrence rates (up to 70% within 12 months), impacting quality of life and healthcare costs. Although several factors associated with venous leg ulcer recurrence have been identified, evidence integrating clinical, sociodemographic, functional, and behavioural characteristics in relation to both recurrence occurrence and recurrence risk remains limited. This study aimed to analyse factors associated with venous leg ulcer recurrence within the previous 12 months and with 12-month recurrence risk among people with a history of venous leg ulcer recurrence living in inland Portugal. A quantitative, cross-sectional, correlational study was conducted with 208 adults recruited from three Portuguese healthcare institutions. Data were collected using questionnaires and analysed using descriptive statistics, non-parametric tests, binary logistic regression and ordinal logistic regression. Participants were mostly older adults (72.86 ± 12.18 years), had a high mean body mass index, and presented multiple comorbidities. Recurrence within the previous 12 months occurred in 70% of participants with available data. In the adjusted binary logistic regression model, older age (aOR = 1.061; 95% CI: 1.022-1.102), history of deep vein thrombosis (aOR = 17.275; 95% CI: 3.154-94.624), presence of sadness (aOR = 2.558; 95% CI: 1.077-6.075), non-use of preventive compression (aOR = 3.836; 95% CI: 1.584-9.291), and educational attainment were associated with recurrence within the previous 12 months. In the ordinal logistic regression model, older age (aOR = 1.046; 95% CI: 1.013-1.081), walking independently (aOR = 0.286; 95% CI: 0.097-0.844), daily skin hydration (aOR = 0.396; 95% CI: 0.176-0.889), and recurrence within the previous 12 months (aOR = 57.7; 95% CI: 19.5-170.9) were associated with recurrence-risk level. Venous leg ulcer recurrence is a multifactorial phenomenon associated with clinical, functional, behavioural and psychosocial characteristics. These findings support individualised, multidimensional prevention strategies that integrate clinical assessment, functional capacity, preventive behaviours and continued care after ulcer healing.