Impact of different follow-up methods on prognosis of diabetic foot patients after endovascular treatment: a multicenter retrospective cohort study.
4 affiliations
- 1Department of Vascular Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
- 2Department of Vascular Surgery, Shanghai TCM-Integrated Hospital, Shanghai University of TCM, Shanghai, China.
- 3Department of General Medicine, Changhai Community Health Service Center, Yangpu District, Shanghai, China.
- 4Department of Interventional Vascular Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
Abstract
Diabetic foot ulcer (DFU) is a severe complication of diabetes mellitus, and endovascular treatment (EVT) has become the primary revascularization strategy. However, the impact of different post-procedure follow-up methods on clinical outcomes remains unclear. This study aimed to compare the effects of seven different follow-up approaches on prognosis in DFU patients after EVT. This multicenter retrospective cohort study was conducted at three tertiary hospitals in China between June 2022 and June 2025. A total of 868 DFU patients who underwent successful EVT were enrolled and categorized into seven groups based on their primary follow-up method. The primary outcomes were 12-month wound healing rate and amputation-free survival (AFS). Secondary outcomes included major adverse limb events (MALE), reintervention rate, patient satisfaction, and glycemic control. Multivariable Cox regression and propensity score matching were used to adjust for confounders. Among 868 patients, the surgical hospital outpatient group demonstrated the highest 12-month wound healing rate (75.0%) and AFS rate (80.1%). The no follow-up group had the poorest outcomes (45.2% wound healing, 56.4% AFS). No follow-up was associated with significantly increased risk of MALE [adjusted hazard ratio (aHR) 2.15, 95% confidence interval (CI): 1.62-2.85]. WeChat follow-up (aHR 1.22, 95% CI: 0.88-1.69) showed non-significant differences compared with surgical hospital outpatient follow-up. Structured follow-up significantly improves wound healing and AFS in DFU patients after EVT. Digital health tools such as WeChat showed no statistically significant difference compared with traditional follow-up, but these observational data should not be interpreted as evidence of equivalent effectiveness. The absence of follow-up is associated with substantially worse outcomes. These findings are hypothesis-generating and warrant validation in prospective randomized trials.
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BibTeX
@article{li2026impact,
title = {{Impact of different follow-up methods on prognosis of diabetic foot patients after endovascular treatment: a multicenter retrospective cohort study.}},
author = {Dazhi Li and Jialong Li and Maoji Ying and Haoran Hu and Peng Du and Qingsheng Lu},
journal = {MHealth},
year = {2026},
month = sep,
doi = {10.21037/mhealth-2026-0041},
url = {https://europepmc.org/article/MED/42999581},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Impact of different follow-up methods on prognosis of diabetic foot patients after endovascular treatment: a multicenter retrospective cohort study.
AU - Dazhi Li
AU - Jialong Li
AU - Maoji Ying
AU - Haoran Hu
AU - Peng Du
AU - Qingsheng Lu
PY - 2026
DA - 2026/09/30
JO - MHealth
DO - 10.21037/mhealth-2026-0041
UR - https://europepmc.org/article/MED/42999581
AB - Diabetic foot ulcer (DFU) is a severe complication of diabetes mellitus, and endovascular treatment (EVT) has become the primary revascularization strategy. However, the impact of different post-procedure follow-up methods on clinical outcomes remains unclear. This study aimed to compare the effects of seven different follow-up approaches on prognosis in DFU patients after EVT. This multicenter retrospective cohort study was conducted at three tertiary hospitals in China between June 2022 and June 2025. A total of 868 DFU patients who underwent successful EVT were enrolled and categorized into seven groups based on their primary follow-up method. The primary outcomes were 12-month wound healing rate and amputation-free survival (AFS). Secondary outcomes included major adverse limb events (MALE), reintervention rate, patient satisfaction, and glycemic control. Multivariable Cox regression and propensity score matching were used to adjust for confounders. Among 868 patients, the surgical hospital outpatient group demonstrated the highest 12-month wound healing rate (75.0%) and AFS rate (80.1%). The no follow-up group had the poorest outcomes (45.2% wound healing, 56.4% AFS). No follow-up was associated with significantly increased risk of MALE [adjusted hazard ratio (aHR) 2.15, 95% confidence interval (CI): 1.62-2.85]. WeChat follow-up (aHR 1.22, 95% CI: 0.88-1.69) showed non-significant differences compared with surgical hospital outpatient follow-up. Structured follow-up significantly improves wound healing and AFS in DFU patients after EVT. Digital health tools such as WeChat showed no statistically significant difference compared with traditional follow-up, but these observational data should not be interpreted as evidence of equivalent effectiveness. The absence of follow-up is associated with substantially worse outcomes. These findings are hypothesis-generating and warrant validation in prospective randomized trials.
SN - 2306-9740
ER -