Wang Huijie, Klok Frederikus A, Rosendaal Frits R, Cushman Mary, van Hylckama Vlieg Astrid
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.
Res Pract Thromb Haemost. 2023 Jun 30;7(5):102144. doi: 10.1016/j.rpth.2023.102144. eCollection 2023 Jul.
There is limited information on short- and long-term effects of venous thromboembolism (VTE) on health-related quality of life (HRQoL) in the elderly.
To assess change in generic HRQoL and disease-specific HRQoL in patients 1 year after the VTE.
The Age and Thrombosis, Acquired and Genetic risk factors in the elderly (AT-AGE) study is a 2-center case-control study performed in Leiden, the Netherlands, and Vermont, United States, among individuals aged ≥70 years. We measured generic HRQoL using the 36-item Short Form Health Survey (SF-36) and disease-specific HRQoL using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms Questionnaire (VEINES-QoL/Sym) and the Pulmonary Embolism-Specific Quality of Life Questionnaire (PEmb-QoL). All patients completed these questionnaires shortly after their VTE and 1 year later, while controls completed the 36-item Short Form Health Survey questionnaire once. Linear regression for change in quality of life scores was performed and adjusted for potential confounders.
For the current analysis, we included patients who were visited twice ( = 316) and controls ( = 427) with HRQoL information. Mean age of patients and controls was similar (78.8 vs 75.5 years). In patients who survived at least 1 year after the VTE, generic HRQoL improved for both summary scores, but it did not reach the level of the age-matched controls: physical and mental summary scores increased by 5.6 and 5.5 points, respectively, but compared with controls, remained 8.2 and 6.4 points lower. For disease-specific HRQoL, the Pulmonary Embolism-Specific Quality of Life Questionnaire overall score decreased from 21.7% to 15.2%, indicating improved HRQoL. Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms Questionnaire scores did not change over time.
Overall, the quality of life of patients with VTE was worse than that of controls after 1 year, indicating a long-term impact of VTE diagnosis in the elderly.
关于静脉血栓栓塞症(VTE)对老年人健康相关生活质量(HRQoL)的短期和长期影响的信息有限。
评估VTE发生1年后患者的一般HRQoL和疾病特异性HRQoL的变化。
老年人群中的年龄与血栓形成、获得性和遗传危险因素(AT-AGE)研究是一项在荷兰莱顿和美国佛蒙特州进行的2中心病例对照研究,研究对象为年龄≥70岁的个体。我们使用36项简短健康调查问卷(SF-36)测量一般HRQoL,使用静脉功能不全流行病学和经济研究-生活质量/症状问卷(VEINES-QoL/Sym)和肺栓塞特异性生活质量问卷(PEmb-QoL)测量疾病特异性HRQoL。所有患者在VTE后不久和1年后完成这些问卷,而对照组仅完成一次36项简短健康调查问卷。对生活质量得分的变化进行线性回归分析,并对潜在混杂因素进行校正。
在本次分析中,我们纳入了有HRQoL信息且接受过两次访视的患者(n = 316)和对照组(n = 427)。患者和对照组的平均年龄相似(78.8岁对75.5岁)。在VTE后至少存活1年的患者中,两个综合得分的一般HRQoL均有所改善,但未达到年龄匹配对照组的水平:身体和心理综合得分分别增加了5.6分和5.5分,但与对照组相比,仍分别低8.2分和6.4分。对于疾病特异性HRQoL,肺栓塞特异性生活质量问卷的总体得分从21.7%降至15.2%,表明HRQoL有所改善。静脉功能不全流行病学和经济研究-生活质量/症状问卷得分随时间未发生变化。
总体而言,VTE患者1年后的生活质量比对照组差,表明VTE诊断对老年人有长期影响。