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Effect of Postthrombotic Syndrome on Health-Related Quality of Life After Deep Venous Thrombosis
Susan R. Kahn, MD, MSc;
Andrew Hirsch, MD;
Ian Shrier, MD, PhD
Arch Intern Med. 2002;162:1144-1148.
Background Postthrombotic syndrome (PTS) is a frequent chronic complication of
deep venous thrombosis, yet its impact on health-related quality of life has
not been well characterized. We compared generic and venous disease–specific
quality of life in patients with and without PTS, and assessed whether quality
of life correlated with severity of PTS.
Methods Subjects with previous deep venous thrombosis were participants in a
study of the effects of exercise after deep venous thrombosis. We ascertained
PTS and its severity using a validated clinical scale. Subjects completed
generic (the 36-Item Short-Form Health Survey) and disease-specific (Venous
Insufficiency Epidemiologic and Economic Study quality-of-life questionnaire
[VEINES-QOL] and its validated subscale of 10 items on venous symptoms [VEINES-Sym])
quality-of-life measures. Age- and sex-adjusted mean quality-of-life scores
were compared in patients with and without PTS, and by severity of PTS.
Results Of the 41 subjects (mean age, 51.2 years), 19 (46%) had PTS. Subjects
with PTS had significantly worse disease-specific quality-of-life scores than
those without PTS (mean ± SD VEINES-QOL score, 44.5 ± 11.6 vs
54.8 ± 5.4, respectively [P<.001]; mean
± SD VEINES-Sym score, 45.6 ± 11.4 vs 54.1 ± 6.7, respectively
[P = .003]), which worsened significantly with increasing
severity of PTS. We found no differences in generic quality-of-life scores
between subject groups.
Conclusions Postthrombotic syndrome has a significant impact on disease-specific
quality of life that may not be captured by generic quality-of-life measures.
Patient-based quality-of-life measures correlated well with physician-assessed
PTS. Further research is indicated to assess the value of including quality
of life as a routine measure of outcome in clinical studies of patients with
deep venous thrombosis and PTS.
From the Department of Medicine (Drs Kahn and Hirsch) and the Center
for Clinical Epidemiology and Community Studies (Drs Kahn and Shrier), Sir
Mortimer B. Davis Jewish General Hospital, Montreal, Quebec.
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