Abstract 16922: One-Year Latent Health Status Trajectories in Patients With Symptomatic Peripheral Artery Disease

Abstract

Background: Symptomatic peripheral artery disease (PAD) can dramatically impact health status. We aimed to characterize typical health status trajectories following initiation of PAD specialty care and to identify demographic, medical, and psychosocial predictors of suboptimal recovery. Methods: Adults with new or worsening PAD (Rutherford 1-3) presenting to vascular clinics in the US, Australia, and Netherlands 2011-2015 in the PORTRAIT study were included. Demographics, comorbidities, and psychosocial measures including the EQ-5D (generic health status), PHQ-8 (depression), GAD-2 (anxiety), PSS (stress), ESSI (social support) were obtained upon initial evaluation. Peripheral Artery Questionnaires (PAQ; 0-100, higher = better PAD-specific health status) were administered at 0, 3, 6, and 12 months. Latent trajectory modeling was used to identify typical PAQ score trajectories by Bayesian information criterion. Predictors of favorable vs. poor recovery trajectory (<10-point PAQ increase at 1 year) were assessed by logistic regression. Missingness was handled by multiple imputation. Results: The final cohort included 1,204 patients, had a mean age of 67.5 (±9.4) years, was 62.5% male, and 82.1% white. A 5-group model best fit the data (Figure). At 1 year, the High (n=401), Intermediate (n=400), and Sustained Response (n=98) groups demonstrated “favorable” mean PAQ changes of +16.8 , +24.0, and +59.4 points, respectively. The Low (n=150) and Transient Response (n=155) groups demonstrated “poor” recovery of +8.6 and +7.6 points, respectively. Significant predictors of poor recovery included age, nonwhite race, worse EQ-5D, and worse PHQ-8 (all p<0.05). Conclusion: Patients with symptomatic PAD follow predictable health status trajectories after initiating care. Poor recovery trajectory is predicted by age, nonwhite race, worse generic health status, and depressive symptom burden. Further emphasis should be placed on these factors during treatment.