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Thromb Haemost 2016; 116(03): 417-431
DOI: 10.1160/TH16-02-0152
Coagulation and Fibrinolysis
Schattauer GmbH

What is the effect of venous thromboembolism and related complications on patient reported health-related quality of life?

A meta-analysis
Bart Lubberts
1   Orthopaedic Foot and Ankle Service, Massachusetts General Hospital – Harvard Medical School, Boston, Massachusetts, USA
,
Nuno Rui Paulino Pereira
2   Orthopaedic Spine and Oncology Service, Massachusetts General Hospital – Harvard Medical School, Boston, Massachusetts, USA
,
Christopher Kabrhel
3   Department of Emergency Medicine, Massachusetts General Hospital – Harvard Medical School, Boston, Massachusetts, USA
,
David J. Kuter
4   Clinical Hematology, Massachusetts General Hospital – Harvard Medical School, Boston, Massachusetts, USA
,
Christopher W. DiGiovanni
1   Orthopaedic Foot and Ankle Service, Massachusetts General Hospital – Harvard Medical School, Boston, Massachusetts, USA
› Author Affiliations
Further Information

Publication History

Received: 22 February 2016

Accepted after major revision: 19 May 2016

Publication Date:
11 November 2017 (online)

Also available at
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Summary

We conducted a meta-analysis of the literature to 1) assess the health-related quality of life for patients with a minimum follow-up of one year after an episode of pulmonary embolism (PE) or deep-vein thrombosis (DVT), and 2) to assess the HRQOL for patients who develop chronic thromboembolic pulmonary hypertension (CTEPH) and post thrombotic syndrome (PTS). PubMed, EMBASE, and the Cochrane Library were searched from inception to March 30, 2016. Data were pooled using random-effects meta-analysis, and heterogeneity was assessed with I2 and Tau2 tests. SF-12, SF-36, and VEINES-QOL were evaluated with pooled standardised mean difference (SMD) and 95% confidence intervals (CI). Fourteen studies were included for meta-analysis. In patients who sustain a PE, physical health becomes impaired (p<0.001, 2 studies) but mental health appears to remain similar to population norms (p=0.069, 2 studies) after at least one year. Patients who develop CTEPH report worse physical (p<0.001, 1 study) and mental health (p=0.009, 1 study). In patients who suffer from a DVT, physical health (p=0.19, 9 studies), mental health (p=0.67, 9 studies), and disease specific quality of life (p=0.61, 8 studies) remain similar to population norms after at least one year. Patients who develop PTS, however, report worse physical health (p<0.001, 7 studies), mental health (p<0.001, 7 studies), and disease specific quality of life (p<0.001, 10 studies). These data can be used to educate patients during the shared decision making process that increasingly governs medical care today. Level of Evidence: II.

Supplementary Material to this article is available online at www.thrombosis-online.com.

Keywords

Quality of life - meta-analysis - chronic thromboembolic pulmonary hypertension - post-thrombotic syndrome - venous thromboembolism

 

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