Magyar, Ursula; Stalder, Odile; Baumgartner, Christine; Méan, Marie; Righini, Marc; Schuetz, Philipp; Bassetti, Stefano; Rodondi, Nicolas; Tritschler, Tobias; Aujesky, Drahomir (2024). Association between severity of pulmonary embolism and health-related quality of life. Journal of thrombosis and haemostasis, 22(2), pp. 516-525. Elsevier 10.1016/j.jtha.2023.10.016
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Background: Health-related quality of life (QoL) impairment is common after pulmo-
nary embolism (PE). Whether the severity of the initial PE has an impact on QoL is
unknown.
Objectives: To evaluate the association between severity of PE and QoL over time.
Methods: We prospectively assessed PE-specific QoL using the Pulmonary Embolism
Quality of Life (lower scores indicate better QoL) questionnaire and generic QoL using
the Short Form 36 (higher scores indicate better QoL) questionnaire at baseline and 3
and 12 months in older patients with acute PE. We examined whether QoL differed by
PE severity based on hemodynamic status, simplified Pulmonary Embolism Severity
Index (sPESI), right ventricular function, and high-sensitivity troponin T in mixed-effects
models, adjusting for known QoL predictors after PE.
Results: Among 546 patients with PE (median age, 74 years), severe vs nonsevere PE
based on the sPESI was associated with a worse PE-specific (adjusted mean Pulmonary
Embolism Quality of Life score difference of 6.1 [95% CI, 2.4-9.8] at baseline, 7.6 [95%
CI, 4.0-11.3] at 3 months, and 6.7 [95% CI, 2.9-10.4] at 12 months) and physical generic
QoL (adjusted mean Short Form 36 Physical Component Summary score difference
of −3.8 [95% CI, −5.5 to −2.1] at baseline, −4.8 [95% CI, −6.4 to −3.1] at 3 months,
and −4.1 [95% CI, −5.8 to −2.3] at 12 months). Elevated troponin levels were also
associated with lower PE-specific QoL at 3 months and lower physical generic QoL at 3
and 12 months. QoL did not differ by hemodynamic status or right ventricular function.
Conclusion: Severe PE based on the sPESI was consistently associated with worse PE-
specific and physical generic QoL over time as compared to nonsevere PE.
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