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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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