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DOI: 10.1055/s-0044-1779066
Anxiety and quality of life in the acute and post-acute phase after venous thromboembolism
Introduction Venous thromboembolism (VTE) is associated with various short- and long-term complications, including psychological distress and deterioration of quality of life. We aimed to describe self-reported anxiety and generic quality of life from diagnosis up to three months after VTE.
Method We conducted a prospective cohort study including unselected VTE patients within 21 days of diagnosis at a tertiary care center. Patients with anticoagulation at the time of diagnosis were excluded. After three months, patients underwent a follow-up visit incorporated into routine clinical care. Anxiety was assessed with the Patient-Reported Outcomes Measurement Information System (PROMIS) short form 8a at baseline and follow-up. Using an online tool, a standardized T-score was calculated from the raw scores, with higher values indicating a higher degree of anxiety. The reference value is derived from a general population, with a mean of 50 and a standard deviation of 10. Quality of life was assessed with the EuroQoL Group 5-Dimension 5-Level (EQ-5D-5L) questionnaire and visual analogue scale (VAS). Based on a reference value set, answers from questions dealing with five dimensions were integrated into an overall index ranging from -0.661 to 1. For both index and visual analogue scale, higher values indicate better quality of life.
Results We included 321 patients with a median (interquartile, IQR) age of 55.6 (43.4-66.1) years; 138 (43.0%) were women. Nearly 50% of all patients had pulmonary embolism, median (IQR) BMI was 27.7 (24.4-31.4) kg/m², 91 (28.3%) reported a history of VTE, and 79 (24.6%) reported a history of cardiovascular or pulmonary disease. At baseline, 301 patients with available data had a mean (standard deviation) anxiety T-score of 51.1 (9.3). After three months, anxiety T-score improved to 46.8 (9.1), reflecting a mean change of -4.1 from baseline (data available for 254 patients). However, 60 patients (23.6% of patients with available data) reported increased levels of anxiety at three months ([Fig. 1]). Median (IQR) EQ-5D-5L index for 312 patients at baseline was 0.85 (0.68-0.92). At follow-up, data was available for 263 patients, with a median (IQR) of 0.90 (0.88-1.00). Overall, 17.8% reported a decrease in quality of life compared to baseline. Regarding VAS, median (IQR) values at baseline and follow-up were 70 (50-80) and 80 (70-90), respectively ([Fig. 2]; data available for 307 and 262 patients, respectively). Similar to the index, 46 patients (17.8%) reported a decreased quality of life compared to baseline.
Conclusion During the three months following a VTE diagnosis, self-reported anxiety and generic quality of life of patients improved overall. However, a considerable proportion of patients reported increased levels of anxiety and decreased levels of quality of life, necessitating a better understanding and further investigation of this group.
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Conflict of Interest
DS, SN, and BW report no conflicts of interest. CA received personal fees for lectures and/or participation in advisory boards from Bayer, BMS, Daiichi-Sankyo, Pfizer, and Sanofi.
Publikationsverlauf
Artikel online veröffentlicht:
26. Februar 2024
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