Kahn Susan R, Ducruet Thierry, Lamping Donna L, Arsenault Louise, Miron Marie Jose, Roussin Andre, Desmarais Sylvie, Joyal France, Kassis Jeannine, Solymoss Susan, Desjardins Louis, Johri Mira, Shrier Ian
Centre for Clinical Epidemiology and Community Studies, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada.
Arch Intern Med. 2005 May 23;165(10):1173-8. doi: 10.1001/archinte.165.10.1173.
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.
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.
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.
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.
据我们所知,从患者角度来看,深静脉血栓形成的负担尚未得到量化。我们评估了深静脉血栓形成后的健康相关生活质量(QOL),并将结果与一般人群的标准进行了比较。
这是一项多中心前瞻性队列研究,在加拿大7家医院中心连续招募了359例符合条件的深静脉血栓形成患者。在基线以及诊断后1个月和4个月时,使用通用量表(36项简短健康调查问卷)和疾病特异性量表(静脉功能不全流行病学和经济学研究[VEINES]-QOL问卷及VEINES症状[VEINES-Sym]问卷)对生活质量进行评估。计算4个月期间QOL评分的变化,并评估QOL改善不足的决定因素。
在4个月期间,36项简短健康调查问卷的身体和心理成分汇总评分平均分别提高了5.1分和4.6分,VEINES-QOL和VEINES-Sym评分分别提高了3.1分和2.2分(所有量表的时间趋势P <.001)。然而,约三分之一的患者在随访期间QOL恶化。多变量分析显示,血栓形成后综合征评分恶化是36项简短健康调查问卷身体成分汇总评分恶化(P =.04)、VEINES-QOL评分恶化(P <.001)和VEINES-Sym评分恶化(P <.001)的独立预测因素。在所有评估时间点,36项简短健康调查问卷身体成分汇总评分均低于人群标准。
平均而言,深静脉血栓形成后的4个月内QOL有所改善。然而,约三分之一的患者QOL恶化,在4个月时,平均QOL仍低于人群标准。血栓形成后综合征评分恶化与QOL恶化相关。