To evaluate health-related quality of life after venous thromboembolism.
Methods
We conducted a cohort study, TEHS follow-up, including 1040 women with a first episode of venous thromboembolism and 994 women unexposed to venous thromboembolism. Patients were recruited from the “Thrombo Embolism Hormonal Study” (TEHS), a Swedish nation-wide case–control study on risk factors for venous thromboembolism in women 18–64 years of age. Quality of life was measured using SF-36 and VEINES-QoL/VEINES-Sym.
Results
On average there were no difference in mean SF-36 summary scales scores between exposed and unexposed women. Twenty percent of exposed women developed postthrombotic syndrome during follow-up. Women with postthrombotic syndrome had severely impaired quality of life with lower scores on all scales. Other predictors of low quality of life after venous thromboembolism were age, obesity, physical inactivity, and recurrent venous thromboembolism.
Conclusion
Long-term quality of life after venous thromboembolism in women was severely impaired among those developing postthrombotic syndrome, while quality of life in women not developing postthrombotic syndrome was similar to a control population.
KahnSRShbakloHLampingDLet al.Determinants of health-related quality of life during the 2 years following deep vein thrombosis. J Thromb Haemost2008; 6: 1105–1112.
2.
KahnSRHirschAShrierI. Effect of postthrombotic syndrome on health-related quality of life after deep venous thrombosis. Arch Intern Med2002; 162: 1144–1148.
KlokFAvan KralingenKWvan DijkAPet al.Quality of life in long-term survivors of acute pulmonary embolism. Chest2010; 138: 1432–1440.
5.
van KorlaarIVossenCRosendaalFet al.Quality of life in venous disease. Thromb Haemost2003; 90: 27–35.
6.
van KorlaarIMVossenCYRosendaalFRet al.The impact of venous thrombosis on quality of life. Thromb Res2004; 114: 11–18.
7.
WikHSEndenTRJacobsenAFet al.Long-term quality of life after pregnancy-related deep vein thrombosis and the influence of socioeconomic factors and comorbidity. J Thromb Haemost2011; 9: 1931–1936.
8.
Wik HS, Jacobsen AF, Sandvik L, et al. Long-term impact of pregnancy-related venous thrombosis on quality-of-life, general health and functioning: results of a cross-sectional, case-control study. BMJ Open 2012; 2: e002048. doi:10.1136/ bmjopen-2012-002048.
9.
PrandoniPLensingAWCogoAet al.The long-term clinical course of acute deep venous thrombosis. Ann Intern Med1996; 125: 1–7.
10.
SchulmanSLindmarkerPHolmstromMet al.Post-thrombotic syndrome, recurrence, and death 10 years after the first episode of venous thromboembolism treated with warfarin for 6 weeks or 6 months. J Thromb Haemost2006; 4: 734–742.
11.
KahnSR. Frequency and determinants of the postthrombotic syndrome after venous thromboembolism. Curr Opin Pulm Med2006; 12: 299–303.
12.
BrandjesDPBullerHRHeijboerHet al.Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis. Lancet1997; 349: 759–762.
13.
TickLWKramerMHRosendaalFRet al.Risk factors for post-thrombotic syndrome in patients with a first deep venous thrombosis. J Thromb Haemost2008; 6: 2075–2081.
14.
PerssonLMLapidusLJLarfarsGet al.Asymptomatic deep venous thrombosis is associated with a low risk of post-thrombotic syndrome. Eur J Vasc Endovasc Surg2009; 38: 229–233.
15.
Wille-JorgensenPJorgensenLNCrawfordM. Asymptomatic postoperative deep vein thrombosis and the development of postthrombotic syndrome. A systematic review and meta-analysis. Thromb Haemost2005; 93: 236–241.
16.
BergendalABremmeKHedenmalmKet al.Risk factors for venous thromboembolism in pre-and postmenopausal women. Thromb Res2012; 130: 596–601.
17.
WareJEJrSherbourneCD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care1992; 30: 473–483.
18.
SullivanMKarlssonJWareJEJr. The Swedish SF-36 Health Survey—I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med1995; 41: 1349–1358.
19.
WareJE KMKellerSD. SF-36® physical and mental health summary scales: a user’s manual, Boston, MA: The Health Institute, 1994.
20.
KahnSRLampingDLDucruetTet al.VEINES-QOL/Sym questionnaire was a reliable and valid disease-specific quality of life measure for deep venous thrombosis. J Clin Epidemiol2006; 59: 1049–1056.
21.
LampingDLSchroterSKurzXet al.Evaluation of outcomes in chronic venous disorders of the leg: development of a scientifically rigorous, patient-reported measure of symptoms and quality of life. J Vasc Surg2003; 37: 410–419.
22.
ChitsikeRSRodgerMAKovacsMJet al.Risk of post-thrombotic syndrome after subtherapeutic warfarin anticoagulation for a first unprovoked deep vein thrombosis: results from the REVERSE study. J Thromb Haemost2012; 10: 2039–2044.
23.
KahnSRPartschHVedanthamSet al.Definition of post-thrombotic syndrome of the leg for use in clinical investigations: a recommendation for standardization. J Thromb Haemost2009; 7: 879–883.
24.
GalanaudJPHolcroftCARodgerMAet al.Predictors of post-thrombotic syndrome in a population with a first deep vein thrombosis and no primary venous insufficiency. J Thromb Haemost2013; 11: 474–480.
25.
GalanaudJPHolcroftCARodgerMAet al.Comparison of the Villalta post-thrombotic syndrome score in the ipsilateral vs. contralateral leg after a first unprovoked deep vein thrombosis. J Thromb Haemost2012; 10: 1036–1042.
26.
KahnSRShrierIJulianJAet al.Determinants and time course of the postthrombotic syndrome after acute deep venous thrombosis. Ann Intern Med2008; 149: 698–707.
27.
WikHSJacobsenAFSandvikLet al.Prevalence and predictors for post-thrombotic syndrome 3 to 16 years after pregnancy-related venous thrombosis: a population-based, cross-sectional, case-control study. J Thromb Haemost2012; 10: 840–847.
28.
BjorckFSandenPRenlundHet al.Warfarin treatment quality is consistently high in both anticoagulation clinics and primary care setting in Sweden. Thromb Res2015; 136: 216–220.
29.
Utne KK, Ghanima W, Foyn S, et al. Development and validation of a tool for patient reporting of symptoms and signs of the post-thrombotic syndrome. Thromb Haemost 2015; 115: 361–367.
