Health-related quality of life and mortality in patients with pulmonary embolism: a prospective cohort study in seven European countries

Abstract

Purpose Little is known about the quality of life following pulmonary embolism (PE). The aim of the study was to assess the 12-month illness burden in terms of health-related quality of life (HrQoL) and mortality, in relation to differences in patient characteristics. Methods The PREFER in VTE registry, a prospective, observational study conducted in seven European countries, was used. Within 2 weeks following an acute symptomatic PE, patients were recruited and followed up for 12 months. Associations between patient characteristics and HrQoL (EQ-5D-5L) and mortality were examined using a regression approach. Results Among 1399 PE patients, the EQ-5D-5L index score at baseline was 0.712 (SD 0.265), which among survivors gradually improved to 0.835 (0.212) at 12 months. For those patients with and without active cancer, the average index score at baseline was 0.658 (0.275) and 0.717 (0.264), respectively. Age and previous stroke were significant factors for predicting index scores in those with/without active cancer. Bleeding events but not recurrences had a noticeable impact on the HrQoL of patients without active cancer. The 12-month mortality rate post-acute period was 8.1%, ranging from 1.4% in Germany, Switzerland, and Austria to 16.8% in Italy. Mortality differed between patients with active cancer and those without (42.7% vs. 4.7%). Conclusion PE is associated with a substantial decrease in HrQoL at baseline which normalizes following treatment. PE is associated with a high mortality rate especially in patients with cancer, with significant country variation. Bleeding events, in particular, impact the burden of PE.

Venous Thromboembolic Disease Among the Lebanese Population: A Retrospective Observational Study

“…One-year mortality was 25% among our PE patients whereas it was 8.1% for PE in Europe, ranging from 1.4% in Germany, Switzerland, and Austria to 16.8% in Italy. Mortality differed between patients with active cancer (42.7%) and those without (4.7%) [10]. Our data showed that the readmission rates for both DVT and PE and one-year mortality was significantly higher in our population in comparison with European countries.…”

A Case-Control Analysis of the Impact of Venous Thromboembolic Disease on Quality of Life of Patients with Cancer: Quality of Life in Cancer (Qca) Study

“…In addition, questionnaires were administered after 4 months and 10 years from the index PE event [14]. The prospective, observational, international PREFER study investigated the QoL of 1399 patients with PE using the EQ-5D-5L questionnaire‚-with a reported score of 0.71 ± 0.27 at the time of event [30]. Only 120 patients (8.6%) in this study had a diagnosis of cancer and disease-specific QoL questionnaires were not utilized.…”

The impact of post-pulmonary embolism syndrome and its possible determinants

“…However, at one year the HRQoL of the study population was comparable to that of the general population, contrasting other studies by indicating normalisation of HRQoL within one year 8 . A recently published study based on the data from the prospectively designed PREFER registry 191 reported a reduced HRQoL, as assessed by the EQ-5D, in 1399 PE patients compared to that of the general population 192 . In this study, improvement of HRQoL overtime was also observed.…”

“…Although, this improvement was mainly driven by the surviving patient population. In addition, they reported several comorbidities as being significant determinants of HRQoL 192 . Nevertheless, this particular topic has been a major subject of debate in which some suggest the impaired HRQoL is caused by comorbidities and/or deconditioning 7 , whereas others argue that possible associations with the PE event itself cannot be ruled out 157 .…”