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Prospective Evaluation of Health-Related Quality of Life in Patients With Deep Venous Thrombosis
Susan R. Kahn, MSc, MD, FRCPC;
Thierry Ducruet, MSc;
Donna L. Lamping, PhD;
Louise Arsenault;
Marie Jose Miron, MD;
Andre Roussin, MD;
Sylvie Desmarais, MD;
France Joyal, MD;
Jeannine Kassis, MD;
Susan Solymoss, MD;
Louis Desjardins, MD;
Mira Johri, PhD;
Ian Shrier, MD, PhD
Arch Intern Med. 2005;165:1173-1178.
Background To our knowledge, the burden of deep venous thrombosis from the patient’s perspective has not been quantified. We evaluated health-related quality of life (QOL) after deep vein thrombosis and compared results with general population norms.
Methods This was a multicenter prospective cohort study of 359 consecutive eligible patients with deep vein thrombosis recruited at 7 Canadian hospital centers. Quality of life was assessed at baseline and at 1 and 4 months after diagnosis using generic (36-Item Short-Form Health Survey) and disease-specific (Venous Insufficiency Epidemiological and Economic Study [VEINES]–QOL and VEINES symptom [VEINES-Sym] questionnaires) measures. Changes in QOL scores during the 4-month period were calculated, and determinants of lack of improvement in QOL were evaluated.
Results During the 4 months, mean 36-Item Short-Form Health Survey physical and mental component summary scores improved by 5.1 and 4.6 points, respectively, and VEINES-QOL and VEINES-Sym scores improved by 3.1 and 2.2 points, respectively (P < .001 for time trend for all measures). However, about one third of patients had worsening of QOL during follow-up. Multivariate analyses showed that worsening of the postthrombotic syndrome score was an independent predictor of worsening of 36-Item Short-Form Health Survey physical component summary (P = .04), VEINES-QOL (P < .001), and VEINES-Sym (P < .001) scores. The 36-Item Short-Form Health Survey physical component summary scores were lower than population norms at all points assessed.
Conclusions On average, QOL improves during the 4 months following deep vein thrombosis. However, in about one third of patients, QOL deteriorates, and at 4 months, average QOL remains poorer than population norms. Worsening of the postthrombotic syndrome score is associated with worsening of QOL.
Author Affiliations: Centre for Clinical Epidemiology and Community Studies, Sir Mortimer B. Davis Jewish General Hospital (Drs Kahn, Johri, and Shrier, Mr Ducruet, and Ms Arsenault), Departments of Medicine (Drs Kahn and Solymoss) and Family Medicine (Dr Shrier), McGill University, and Départements de Médecine (Drs Miron, Roussin, Joyal, and Kassis) et d’administration de la santé (Dr Johri), Université de Montréal, Montreal, Quebec; Health Services Research Unit, London School of Hygiene & Tropical Medicine, London, England (Dr Lamping); Centre Hospitalier Pierre Boucher, Longueuil, Quebec (Dr Desmarais); and Université Laval, Québec (Dr Desjardins).
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