Decreased mobility, lack of social support, haemosiderosis and use of antidepressant medications may predict recurrent venous leg ulcers within 12 months of healing: A prospective longitudinal study

Abstract

To identify clinical, medical and psychosocial predictors of venous leg ulcer recurrence within 12months of healing. A multi-site study was conducted in Australia in community and hospital outpatient settings. Adults with venous leg ulcers were recruited within 4weeks of healing and data were collected on preventative treatments and health, medical, clinical and psychosocial factors. Follow-up data on recurrences were collected every 3months until ulcer recurrence, or until 12months after healing pending which occurred first. Factors associated with time to recurrence were analysed using a Cox proportional hazards regression model. Secondary data analysis of a multi-site, prospective longitudinal study to validate a risk assessment tool for recurrence. A sample of 143 participants was recruited (51% male, Mage = 73years, SD 13.6). Almost half (49.6%) had an ulcer recurrence within 12months, with a mean time to ulcer recurrence of 37weeks (SE 1.63, 95% CI 33.7-40.1). Factors measured at the time of healing that were significant independent predictors of recurrence were: prescribed antidepressant medications (p = .035), presence of haemosiderosis (p = .006), decreased mobility (longer sitting times) (p = .007) and lower social support scale scores (p = .002). Participants who wore compression systems providing 20mmHg or higher for at least 5days/week were less likely to recur, although not reaching statistical significance (p = .06). Results provide evidence that antidepressant medications, haemosiderosis, decreased mobility and lack of social support are risk factors associated with ulcer recurrence; therefore, these variables are modifiable and could guide early intervention.