Health-related quality of life after pulmonary embolism: a cross-sectional study

BMJ Open. 2016 Nov 3;6(11):e013086. doi: 10.1136/bmjopen-2016-013086.

Abstract

Objectives: The psychological effects of acute pulmonary embolism (PE) have scarcely been studied. The aims of this study were to evaluate health-related quality of life (HRQoL) in patients with a history of PE compared with that of the general population and buddy controls, and to explore factors that may predict impaired HRQoL.

Design: Cross-sectional.

Setting: Haematology and thrombosis unit in Fredrikstad, Norway.

Participants: 213 consecutive patients treated for PE were identified from hospital registries. Eligible patients were scheduled for a single study visit, including a functional capacity test (6 min walking test). HRQoL was assessed using the EuroQol 5D dimensions 3-level (EQ-5D-3L) questionnaire, of which the results were compared with Danish population norms and age-matched and sex-matched buddy controls. The buddy controls were recruited by asking every patient to hand over the EQ-5D questionnaire to 2 age-matched and sex-matched friends or relatives. Multivariable regression analyses were used to examine possible determinants of reduced HRQoL.

Results: Mean age was 61 years (SD 15), 117 (55%) were males, and median time since diagnosis was 3.8 years (range 0.3-9.5). Mean EuroQol visual analogue scale (EQ VAS) was 67 in PE as compared with 81 in the general population (p<0.005) and corresponding EQ-5D index values were 0.80 and 0.86 (p<0.005). Patients reported more problems in all 5 EQ-5D compared with both the buddy controls and the general population, p<0.05. Shorter 6 min walking distance (β=0.09, p<0.005) and patient-reported dyspnoea (β=11.27, p<0.005) were independent predictors of lower EQ VAS scores.

Conclusions: Our findings show that patients with a history of PE have impaired HRQoL when compared with the general population and buddy controls. Reduced functional capacity and persistent dyspnoea were the main predictors of this impairment.

Keywords: cross-sectional; exercise tolerance; pulmonary embolism; quality of life.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Cross-Sectional Studies
  • Dyspnea
  • Female
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Norway
  • Pulmonary Embolism / complications*
  • Quality of Life*
  • Surveys and Questionnaires
  • Walking