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Original Research: PULMONARY EMBOLISM |

Quality of Life in Long-term Survivors of Acute Pulmonary Embolism

Frederikus A. Klok, MD, PhD; Klaas W. van Kralingen, MD, PhD; Arie P. J. van Dijk, MD, PhD; Fenna H. Heyning, MD, PhD; Hubert W. Vliegen, MD, PhD; Ad A. Kaptein, MD, PhD; Menno V. Huisman, MD, PhD
Author and Funding Information

From the Section of Vascular Medicine (Drs Klok and Huisman), Department of General Internal Medicine-Endocrinology; Departments of Pulmonary Medicine and Medical Psychology (Drs van Kralingen and Kaptein); and Department of Cardiology (Dr Vliegen), Leiden University Medical Center, Leiden; Department of Cardiology (Dr van Dijk), Radboud University Nijmegen Medical Center, Nijmegen; and Department of Hematology (Dr Heyning), Medical Center Haaglanden, The Hague, The Netherlands.

Correspondence to: Frederikus A. Klok, Leiden University Medical Center (C4-70), Albinusdreef 2, Postbus 9600, 2300 RC, Leiden, The Netherlands; e-mail: F.A.Klok@LUMC.nl


Funding/Support: The study was supported by an unrestricted research grant from Actelion Pharmaceuticals Ltd.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(6):1432-1440. doi:10.1378/chest.09-2482
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Background:  To our knowledge, 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 outcome component 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 nine subscales of the SF-36 were compared with sex- and age-adjusted Dutch population norms. Single and multivariate analyses were performed to identify independent determinants of the QoL in our study population.

Results:  The SF-36 was completed by 392 patients. Except for the health change subscale, patients had substantially lower QoL than population norms on all eight 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 that included all identified significant determinants proved to be quite modest predictors for QoL in the individual patient. Awareness of illness, coping mechanisms, and self-management behavior might be additional important indicators of QoL in our study population but require further investigation.

Conclusion:  We identified several PE- and non-PE-related determinants of QoL in patients with a history of acute PE, which is impaired compared with sex- and age-adjusted population norms. QoL after acute PE should be studied more extensively and added as a standard measure to outcome studies.

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