Silva Joana Cruz, Constâncio Vânia, Lima Pedro, Nunes Celso, Silva Eduardo, Anacleto Gabriel, Fonseca Manuel
Angiology and Vascular Surgery Department, Centro Hospitalar e Universitário de Coimbra, Praceta Rua Prof. Mota Pinto, Coimbra, Portugal.
Angiology and Vascular Surgery Department, Centro Hospitalar e Universitário de Coimbra, Praceta Rua Prof. Mota Pinto, Coimbra, Portugal.
Ann Vasc Surg. 2022 Sep;85:253-261. doi: 10.1016/j.avsg.2022.03.002. Epub 2022 Mar 23.
Chronic post-thrombotic syndrome (PTS) may develop in up to 50% of patients after deep vein thrombosis (DVT), and may reduce patients' quality of life (QoL). We aimed to evaluate the association of PTS severity with QoL in patients with proximal DVT submitted for medical treatment and also to identify modifiable and non-modifiable risk factors related to PTS.
Patients with iliac or femoropopliteal DVT observed in Vascular Surgery consultation in our institution from 1 year period with unilateral DVT were selected. Patients with total vein recanalization were excluded. Villalta scale was applied to assess PTS degree and VEINES-QoL/Sym questionnaire was used as a disease-specific QoL measure. Correlation between PTS degree and VEINES-QoL/Sym score and predictors of PTS were determined.
Fifty-six patients were accepted to enter the study. From those, 66.1% were female, 64.3% (n = 36) had iliac and 35.7% (n = 20) femoropopliteal DVT. PTS was present in 52.8% of iliac and 65.0% of femoropopliteal DVT patients observed for consultation (P = 0.41). There was a significant correlation with PTS degree and both VEINES-QoL and VEINES-Sym scores (P < 0.01). Major depression (odds ratio OR = 5.63, P = 0.04) and regular wear of compressing stockings (OR = 4.69, P = 0.04) were the only independent factors associated with PTS. Patients with depression had lower QoL scores, while patients with PTS who wear compression stockings had similar QoL scores compared to patients without PTS. Ultrasound alterations (OR = 3.28, P = 0.17), age, gender, iliac DVT, multiple DVT and time after DVT (P > 0.20) were not associated with PTS syndrome.
VEINES-QoL/Sym had moderate inverse correlation with PTS degree. Depression was associated with both PTS and lower QoL scores. Patients with PTS criteria compliant to wearing compressing stockings had similar QoL scores to patients without PTS.
慢性血栓后综合征(PTS)在深静脉血栓形成(DVT)患者中发生率高达50%,可能会降低患者的生活质量(QoL)。我们旨在评估接受药物治疗的近端DVT患者中PTS严重程度与QoL之间的关联,并确定与PTS相关的可改变和不可改变的危险因素。
选取我院血管外科门诊1年内观察到的单侧髂股或股腘静脉DVT患者。排除静脉完全再通的患者。应用Villalta量表评估PTS程度,采用VEINES-QoL/Sym问卷作为特定疾病的QoL测量工具。确定PTS程度与VEINES-QoL/Sym评分之间的相关性以及PTS的预测因素。
56例患者纳入研究。其中,66.1%为女性,64.3%(n = 36)为髂股静脉DVT,35.7%(n = 20)为股腘静脉DVT。接受门诊观察的髂股静脉DVT患者中52.8%出现PTS,股腘静脉DVT患者中65.0%出现PTS(P = 0.41)。PTS程度与VEINES-QoL和VEINES-Sym评分均显著相关(P < 0.01)。重度抑郁(比值比OR = 5.63,P = 0.04)和经常穿着压力袜(OR = 4.69,P = 0.04)是与PTS相关的仅有的独立因素。抑郁患者的QoL评分较低,而穿着压力袜的PTS患者与未患PTS的患者QoL评分相似。超声改变(OR = 3.28,P = 0.17)、年龄、性别、髂股静脉DVT、多发DVT以及DVT后的时间(P > 0.20)与PTS综合征无关。
VEINES-QoL/Sym与PTS程度呈中度负相关。抑郁与PTS和较低的QoL评分均相关。符合PTS标准且穿着压力袜的患者与未患PTS的患者QoL评分相似。