Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN.
Division of Geriatrics Department of Medicine University of Mississippi Medical Center Jackson MS.
J Am Heart Assoc. 2020 Jun 16;9(12):e015656. doi: 10.1161/JAHA.119.015656. Epub 2020 Jun 1.
Background Relatively little is known about the long-term consequences of venous thromboembolism (VTE) on physical functioning. We compared long-term frailty status, physical function, and quality of life among survivors of VTE with survivors of coronary heart disease (CHD) and stroke, and with those without these diseases. Methods and Results Cases of VTE, CHD, and stroke were continuously identified since ARIC (Atherosclerosis Risk in Communities Study) recruitment during 1987 to 1989. Functional measures were objectively captured at ARIC clinic visits 5 (2011-2013) and 6 (2016-2017); quality of life was self-reported. The 6161 participants at visit 5 were, on average, 75.7 (range, 66-90) years of age. By visit 5, 3.2% had had a VTE, 6.9% CHD, and 3.4% stroke. Compared with those without any of these conditions, VTE survivors were more likely to be frail (odds ratio [OR], 3.11; 95% CI, 1.80-5.36) and have low (<10) versus good scores on the Short Physical Performance Battery (OR, 3.59; 95% CI, 2.36-5.47). They also had slower gait speed, less endurance, and lower physical quality of life. VTE survivors were similar to coronary heart disease and stroke survivors on categorical frailty and outcomes on Short Physical Performance Battery assessment. When score on the Short Physical Performance Battery instrument was modeled continuously, VTE survivors performed better than stroke survivors but worse than CHD survivors. Conclusions VTE survivors had triple the odds of frailty and poorer physical function than those without the vascular diseases considered. Their function was somewhat worse than that of CHD survivors, but better than stroke survivors. These findings suggest that VTE patients may benefit from additional efforts to improve postevent physical functioning.
关于静脉血栓栓塞症(VTE)对身体功能的长期影响,我们知之甚少。我们比较了 VTE 幸存者、冠心病(CHD)幸存者和中风幸存者与无这些疾病的幸存者的长期虚弱状态、身体功能和生活质量。
自 1987 年至 1989 年 ARIC(社区动脉粥样硬化风险研究)招募以来,我们连续确定了 VTE、CHD 和中风的病例。在 ARIC 临床就诊 5 次(2011-2013 年)和 6 次(2016-2017 年)时,客观地测量了功能指标;生活质量是自我报告的。在第 5 次就诊时,6161 名参与者的平均年龄为 75.7 岁(范围为 66-90 岁)。到第 5 次就诊时,3.2%的人患有 VTE,6.9%的人患有 CHD,3.4%的人患有中风。与没有这些疾病的人相比,VTE 幸存者更有可能虚弱(比值比 [OR],3.11;95%置信区间 [CI],1.80-5.36),并且在短期身体表现电池(OR,3.59;95%CI,2.36-5.47)上的得分较低(<10)。他们的步态速度也较慢,耐力较低,身体生活质量较低。VTE 幸存者在分类虚弱和短期身体表现电池评估结果方面与冠心病和中风幸存者相似。当连续对短期身体表现电池仪器的评分进行建模时,VTE 幸存者的表现优于中风幸存者,但劣于 CHD 幸存者。
VTE 幸存者虚弱的可能性是没有考虑到这些血管疾病的患者的三倍,身体功能也较差。他们的功能比 CHD 幸存者稍差,但比中风幸存者好。这些发现表明,VTE 患者可能受益于额外努力来改善事件后的身体功能。