Determinants of health-related quality of life during the 2 years following deep vein thrombosis
Determinants of health-related quality of life during the 2 years following deep vein thrombosis
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DOI：
10.1111/j.1538-7836.2008.03002.x
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发表时间：
2008-07-01
影响因子：
10.4
通讯作者：
Ginsberg, J. S.
中科院分区：
文献类型：
--
作者：
Kahn, S. R.;Shbaklo, H.;Ginsberg, J. S.
背景/目标：我们前瞻性地测量了深静脉血栓形成（DVT）诊断后2年内生活质量（QOL）的变化，并评估了QOL的决定因素，包括血栓后综合征（PTS）的发展。患者/方法：2001年至2004年在加拿大的8家医院招募了急性DVT的连续性患者。在基线和1、4、8、12和24个月的研究访视时，收集临床数据，进行标准化PTS评估，并自行完成QOL问卷。使用简明健康调查-36（SF-36）问卷测量一般QOL。使用静脉功能不全流行病学和经济学研究（VEINES）-QOL/Sym问卷测量静脉疾病特异性QOL。评估了2年随访期间QOL评分的变化。使用多变量回归分析评估PTS和其他特征对2年时QOL的影响。结果：在387例患者中，平均年龄为56岁，三分之二是门诊患者，60%有近端DVT。PTS的累积发生率为47%。平均而言，QOL评分在随访期间有所改善。然而，发生PTS的患者在所有访视时的评分较低，QOL随时间的改善显著较少（PCS、MCS、VEINES-QOL和VEINES-Sym的PTS* 时间相互作用的P值分别为0.001、0.012、0.014和0.006）。多变量回归分析显示，PTS（P < 0.0001）、年龄（P = 0.0009）、近端DVT（P = 0.01）和住院状态（P = 0.04）独立预测2年SF-36 PCS评分。PTS单独独立预测2年VEINES-QOL（P < 0.0001）和VEINES-Sym（P < 0.0001）评分。结论：下肢深静脉血栓形成2年后，PTS的发展是健康相关生活质量的主要决定因素。我们的研究提供了DVT后患者报告结果的预后信息，并强调需要有效预防和治疗PTS。
Background/objectives: We prospectively measured change in quality of life (QOL) during the 2 years after a diagnosis of deep vein thrombosis (DVT) and evaluated determinants of QOL, including development of the post-thrombotic syndrome (PTS). Patients/methods: Consecutive patients with acute DVT were recruited from 2001 to 2004 at eight hospitals in Canada. At study visits at baseline, and 1, 4, 8, 12 and 24 months, clinical data were collected, standardized PTS assessments were performed, and QOL questionnaires were self-completed. Generic QOL was measured using the Short-Form Health Survey-36 (SF-36) questionnaire. Venous disease-specific QOL was measured using the Venous Insufficiency Epidemiological and Economic Study (VEINES)-QOL/Sym questionnaire. The change in QOL scores over a 2-year follow-up was assessed. The influence of PTS and other characteristics on QOL at 2 years was evaluated using multivariable regression analyses. Results: Among the 387 patients recruited, the average age was 56 years, two-thirds were outpatients, and 60% had proximal DVT. The cumulative incidence of PTS was 47%. On average, QOL scores improved during follow-up. However, patients who developed PTS had lower scores at all visits and significantly less improvement in QOL over time (P-values for PTS*time interaction were 0.001, 0.012, 0.014 and 0.006 for PCS, MCS, VEINES-QOL and VEINES-Sym). Multivariable regression analyses showed that PTS (P < 0.0001), age (P = 0.0009), proximal DVT (P = 0.01) and inpatient status (P = 0.04) independently predicted 2-year SF-36 PCS scores. PTS alone independently predicted 2-year VEINES-QOL (P < 0.0001) and VEINES-Sym (P < 0.0001) scores. Conclusions: Development of PTS is the principal determinant of health-related QOL 2 years after DVT. Our study provides prognostic information on patient-reported outcomes after DVT and emphasizes the need for effective prevention and treatment of the PTS.