Kahn Susan R, Hirsch Andrew, Shrier Ian
Center for Clinical Epidemiology and Community Studies, Sir Mortimer B. Davis Jewish General Hospital, 3755 Cote Ste, Catherine Room A-114, Montreal, Quebec, Canada H3T 1E2.
Arch Intern Med. 2002 May 27;162(10):1144-8. doi: 10.1001/archinte.162.10.1144.
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.
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.
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.
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.
血栓形成后综合征(PTS)是深静脉血栓形成常见的慢性并发症,但其对健康相关生活质量的影响尚未得到充分描述。我们比较了有和没有PTS的患者的一般生活质量和静脉疾病特异性生活质量,并评估生活质量是否与PTS的严重程度相关。
既往有深静脉血栓形成的受试者参与了一项关于深静脉血栓形成后运动效果的研究。我们使用经过验证的临床量表确定PTS及其严重程度。受试者完成了一般生活质量测量(36项简短健康调查)和疾病特异性生活质量测量(静脉功能不全流行病学和经济研究生活质量问卷[VEINES-QOL]及其经过验证的关于静脉症状的10项子量表[VEINES-Sym])。比较了有和没有PTS的患者以及不同PTS严重程度患者的年龄和性别调整后的平均生活质量得分。
在41名受试者(平均年龄51.2岁)中,19名(46%)患有PTS。患有PTS的受试者的疾病特异性生活质量得分明显低于没有PTS的受试者(平均±标准差VEINES-QOL得分分别为44.5±11.6和54.8±5.4[P<0.001];平均±标准差VEINES-Sym得分分别为45.6±11.4和54.1±6.7[P = 0.003]),且随着PTS严重程度的增加显著恶化。我们发现受试者组之间的一般生活质量得分没有差异。
血栓形成后综合征对疾病特异性生活质量有显著影响,而一般生活质量测量可能无法体现这一点。基于患者的生活质量测量与医生评估的PTS密切相关。有必要进行进一步研究,以评估将生活质量纳入深静脉血栓形成和PTS患者临床研究的常规结局测量指标的价值。