Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada.
McMaster University Medical Center, Hamilton Health Sciences, Hamilton, Ontario, Canada.
J Vasc Surg Venous Lymphat Disord. 2021 Sep;9(5):1257-1265.e2. doi: 10.1016/j.jvsv.2021.01.017. Epub 2021 Feb 4.
We directly compared the Villalta scale and the Venous Clinical Severity Score (VCSS) to determine which of the two measures would be better at capturing clinically important cases of post-thrombotic syndrome (PTS) and PTS severity compared with patient-reported quality of life (QOL) scores.
We performed a secondary analysis of the ATTRACT (acute venous thrombosis: thrombus removal with adjunctive catheter-directed thrombolysis) trial study population. We calculated the correlations of the Villalta scores and VCSSs with QOL scores (short-form 36-item health survey [SF-36] physical component summary [PCS] and mental component summary [MCS]; and VEINES [venous insufficiency epidemiological and economic study]-QOL/symptom [VEINES-QOL/Sym] questionnaire) at each study visit (6, 12, 18, and 24 months of follow-up). The correlation of the random intercept (mean scores) and random slope (rate of change of the scores) among the Villalta scores, VCSS, and VEINES-QOL/Sym scores was assessed using a multivariate longitudinal model.
The median correlation between Villalta scores and VCSSs was 0.72. The median correlation between the Villalta scores and VEINES-QOL and VEINES-Sym scores at all follow-up visits was -0.68 and -0.71, respectively. The median correlation between the Villalta scores and SF-36 PCS and MCS scores was -0.51 and -0.31, respectively. For the VCSSs, the median correlation with the VEINES-QOL and VEINES-Sym scores at all follow-up visits was -0.39 and -0.41, respectively. The median correlation between the VCSSs and SF-36 PCS and MCS scores was -0.32 and -0.13, respectively. The correlations between the random effects in the multivariate longitudinal models showed a similar pattern. The effect of covariate adjustment by age, sex, and body mass index was minor.
The Villalta scores and VCSSs correlated strongly. The Villalta scale showed a substantially greater correlation with venous disease-specific and general QOL scores compared with the correlation with the VCSS. Our findings suggest that when a single scale is used to assess for clinically meaningful PTS, the Villalta scale will better capture the effects of PTS on patient-reported QOL.
我们直接比较了 Villalta 量表和静脉临床严重程度评分（VCSS），以确定这两种测量方法在捕捉临床重要的血栓后综合征（PTS）病例和 PTS 严重程度方面，与患者报告的生活质量（QOL）评分相比，哪一种方法更好。
我们对 ATTRACT（急性静脉血栓形成：血栓切除联合辅助导管定向溶栓）试验研究人群进行了二次分析。我们计算了 Villalta 评分和 VCSS 与 QOL 评分（36 项健康调查短表[SF-36]生理成分综合评分[PCS]和心理成分综合评分[MCS]；以及静脉不足流行病学和经济研究[VEINES]-QOL/症状[VEINES-QOL/Sym]问卷）在每个研究随访时间点（6、12、18 和 24 个月）的相关性。使用多变量纵向模型评估 Villalta 评分、VCSS 和 VEINES-QOL/Sym 评分之间的随机截距（平均评分）和随机斜率（评分变化率）之间的相关性。
Villalta 评分和 VCSS 之间的中位数相关性为 0.72。Villalta 评分与 VEINES-QOL 和 VEINES-Sym 在所有随访时间点的中位数相关性分别为-0.68 和-0.71。Villalta 评分与 SF-36 PCS 和 MCS 评分的中位数相关性分别为-0.51 和-0.31。对于 VCSS，在所有随访时间点与 VEINES-QOL 和 VEINES-Sym 评分的中位数相关性分别为-0.39 和-0.41。VCSS 与 SF-36 PCS 和 MCS 评分的中位数相关性分别为-0.32 和-0.13。多变量纵向模型中随机效应的相关性也呈现出类似的模式。年龄、性别和体重指数的协变量调整效果较小。
Villalta 评分和 VCSS 之间相关性很强。与 VCSS 相比，Villalta 量表与静脉疾病特异性和一般 QOL 评分的相关性更强。我们的研究结果表明，当使用单一量表评估临床有意义的 PTS 时，Villalta 量表将更好地捕捉 PTS 对患者报告的 QOL 的影响。
