Quality of life in long-term survivors of acute pulmonary embolism

Abstract

Abstract BACKGROUND: Studies evaluating the quality of life (QoL) in patients with a history of acute pulmonary embolism (PE) are not available, even though QoL is a key component of outcome of medical care and a predictor of disease specific prognosis. METHODS: As part of a large follow-up study the Short Form-36 (SF-36) was presented to consecutive patients who had survived one or more episodes of acute PE. The results of all 9 subscales of the SF-36 were compared to sex and age adjusted Dutch population norms. Single and multivariate analyses were performed to identify independent determinants of the quality of life in our study population. RESULTS: The SF-36 was completed by 392 patients. Except for the subscale health change, patients had substantially lower QoL than population norms on all 8 remaining subscales. After multivariate analysis, the time interval between the last thromboembolic episode and study inclusion was inversely related to QoL, and significant determinants of poor QoL were prior PE, age, obesity, active malignancy and cardiopulmonary comorbid conditions. Regression models including all identified significant determinants proved to be quite modest predictors for QoL in the individual patient. Illness cognitions, coping mechanisms and self management behaviour might be additional important indicators of QoL in our study population but remain to be studied. CONCLUSION: We identified several PE- and non-PE related determinants of QoL in patients with a history of acute PE, which is impaired compared to sex and age adjusted population norms. QoL after acute PE should be studied more extensively and added as standard measure to outcome studies.