Deschamps, Justine; Choffat, Damien; Limacher, Andreas; Righini, Marc; Beer, Juerg Hans; Baumgartner, Christine; Hugli, Olivier; Aujesky, Drahomir; Mean, Marie (2023). Quality of Life in elderly patients with venous thromboembolism assessed using Patient-Reported Outcome Measures. Journal of thrombosis and haemostasis, 21(11), pp. 3193-3202. Elsevier 10.1016/j.jtha.2023.07.022
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BACKGROUND
We aimed to evaluate the quality of life (QoL), using Patient-Reported Outcome Measures (PROMs), in elderly patients with venous thromboembolism (VTE) and to explore whether VTE complications (recurrence, bleeding or post thrombotic syndrome) had an impact on later QoL.
METHODS
We used data from SWITCO65+, a prospective multicenter cohort of patients aged ≥65 years with acute, symptomatic VTE. Primary outcome was change in QoL up to 24 months, assessed using generic (36-Item Short-Form Health Survey [SF-36], with Physical (PCS) and Mental Component Score (MCS) and disease-specific ([VEINES]-QOL, [VEINES-Sym], and [PEmb]-QoL) PROMs. PROMs scores ranged from 0-100 points, higher scores indicating a better QoL. Longitudinal latent class analysis was used to group patients with similar PCS trajectories. Repeated-measures linear regression analyses were used to assess effects of VTE complications on change in QoL scores.
RESULTS
In 923 patients (median age 75; 54% male), 140 (15%) patients died, 97 (11%) experienced recurrent VTE, and 106 (12%) major bleeding during follow-up. Compared to patients with higher PCS trajectories, patients with lower PCS trajectories were more likely to be older, female, sicker, and less physically active. On average, generic and disease-specific QoL scores improved over time (+11% in PCS, +3% in MCS, +6% in VEINES-QOL and +16% in PEmb-QOL at 3 months). VTE complications was always associated with significantly lower QoL scores (for VTE recurrence: PCS adjusted difference -2.57, 95%CI = -4.47- -0.67).
CONCLUSION
While QoL following VTE tended to improve over time, patients with VTE-related complications had lower QoL than patients without complications.