Long term quality of life after non-intervention for acute iliofemoral deep venous thrombosis

Abstract

Objectives

Significant progress has been made in the diagnosis and management of deep venous thrombosis (DVT). As focus shifts from solely preventing pulmonary embolism (PE) to maximizing long term quality of life (QoL), there is debate on the optimal treatment strategy for acute DVT. The objective of our study was to examine the natural history of patients diagnosed with iliofemoral DVT managed medically to determine patient factors predictive of quality of life over a five-year follow-up.

Methods

All patients diagnosed with iliofemoral DVT by vascular lab at a single tertiary medical center from 2013 to 2021 were retrospectively identified. Medical histories were obtained by chart review and the VEINES-QOL/Sym was administered over the phone. Respondents were grouped by QoL score classifying those with scores >0.6 as “High” and those with scores ≤0.6 as “Low”. Demographic and clinical data was retrospectively analyzed to determine significant predictors of long term QoL after iliofemoral DVT.

Results

79/386 (21%) patients with acute iliofemoral DVT completed our survey. Respondents were mostly non-white (66%) and male (57%) with an average age of 58 (±15). Respondents had hypertension (51%), diabetes (22%), history of smoking (47%), and previously diagnosed DVT (29%) with no significant differences in medical history between the two QoL score groups. Those with “High” QoL scores were more likely to have hyperlipidemia (28% vs 5%, p < .05) and were less likely to have subsequent DVTs (8.8% vs 27.3%, p < .05) or mobility issues (44% vs 82%, p < .05) compared to “Low” QoL scores. The average time to follow up was 58 months.

Conclusions

Iliofemoral DVTs have a significant impact on quality of life and cause persistent symptoms years after initial diagnosis. A history of recurrent DVTs and mobility issues are the strongest predictors of lower quality of life 5 years after diagnosis.