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

Bart Lubberts; Nuno Rui Paulino Pereira; Christopher Kabrhel; David J. Kuter; Christopher W. DiGiovanni

doi:10.1160/TH16-02-0152

Thrombosis and Haemostasis, Table of Contents

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

¹Orthopaedic Foot and Ankle Service, Massachusetts General Hospital – Harvard Medical School, Boston, Massachusetts, USA

,

Nuno Rui Paulino Pereira

²Orthopaedic Spine and Oncology Service, Massachusetts General Hospital – Harvard Medical School, Boston, Massachusetts, USA

,

Christopher Kabrhel

³Department of Emergency Medicine, Massachusetts General Hospital – Harvard Medical School, Boston, Massachusetts, USA

,

David J. Kuter

⁴Clinical Hematology, Massachusetts General Hospital – Harvard Medical School, Boston, Massachusetts, USA

,

Christopher W. DiGiovanni

¹Orthopaedic Foot and Ankle Service, Massachusetts General Hospital – Harvard Medical School, Boston, Massachusetts, USA

› Author Affiliations

Abstract

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

Full Text

References

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