Kahn S R, M'Lan C E, Lamping D L, Kurz X, Bérard A, Abenhaim L
Center for Clinical Epidemiology & Community Studies, Jewish General Hospital, Montreal, Canada.
J Thromb Haemost. 2004 Dec;2(12):2146-51. doi: 10.1111/j.1538-7836.2004.00957.x.
It is not known whether burden-of-illness differs in chronic venous disease patients with prior venous thromboembolism compared with patients with other forms of chronic venous disease.
To compare severity of disease and quality of life in chronic venous disease patients with and without prior venous thromboembolism.
The VEINES Study population is an international cohort of 1531 outpatients with chronic venous disease in Belgium, France, Italy and Canada. Clinical severity of chronic venous disease graded using the seven-category 'CEAP' scale, and quality of life using standardized generic (SF-36) and venous disease-specific (VEINES-QOL/Sym) questionnaires were compared in patients with and without venous thromboembolism. Multivariable analyses with adjustment for known confounders were used to examine associations between venous thromboembolism and quality of life.
One hundred and fifty-one (10%) patients had prior venous thromboembolism. These patients had more severe chronic venous disease than those without venous thromboembolism (P <0.0001), including a higher frequency of healed or active ulcers (29% vs. 7%, respectively). Multivariable analyses controlling for age, sex, country, education, body mass index, years of chronic venous disease and comorbid conditions demonstrated that prior venous thromboembolism was an independent predictor of poorer generic quality of life (SF-36 Mental Component Summary score, P=0.047; SF-36 Physical Component Summary score, P=0.012) and venous disease-specific quality of life (VEINES-QOL, P = 0.0002; VEINES-Sym, P=0.009).
Disease severity is worse and quality of life poorer in chronic venous disease patients with prior venous thromboembolism compared with patients with other forms of chronic venous disease. Our findings support the need for further research of interventions to prevent and treat the long-term complications of venous thromboembolism.
与患有其他形式慢性静脉疾病的患者相比，既往有静脉血栓栓塞症的慢性静脉疾病患者的疾病负担是否不同尚不清楚。
比较有和没有既往静脉血栓栓塞症的慢性静脉疾病患者的疾病严重程度和生活质量。
VEINES研究人群是来自比利时、法国、意大利和加拿大的1531名慢性静脉疾病门诊患者的国际队列。使用七分类“CEAP”量表对慢性静脉疾病的临床严重程度进行分级，并使用标准化通用问卷（SF-36）和静脉疾病特异性问卷（VEINES-QOL/Sym）对有和没有静脉血栓栓塞症的患者的生活质量进行比较。采用对已知混杂因素进行调整的多变量分析来研究静脉血栓栓塞症与生活质量之间的关联。
151名（10%）患者既往有静脉血栓栓塞症。这些患者的慢性静脉疾病比没有静脉血栓栓塞症的患者更严重（P<0.0001），包括愈合或活动性溃疡的发生率更高（分别为29%和7%）。对年龄、性别、国家、教育程度、体重指数、慢性静脉疾病年限和合并症进行控制的多变量分析表明，既往静脉血栓栓塞症是总体生活质量较差（SF-36心理成分总结评分，P=0.047；SF-36身体成分总结评分，P=0.012）和静脉疾病特异性生活质量较差（VEINES-QOL，P = 0.0002；VEINES-Sym，P=0.009）的独立预测因素。
与患有其他形式慢性静脉疾病的患者相比，既往有静脉血栓栓塞症的慢性静脉疾病患者的疾病严重程度更差，生活质量更低。我们的研究结果支持有必要进一步研究预防和治疗静脉血栓栓塞症长期并发症的干预措施。
