Cardiopulmonary disease, female sex, higher BMI linked with worse QOL after acute PE

In a large cohort of survivors of acute pulmonary embolism, disease-specific and generic health-related quality of life improved between 3 and 12 months, according to data published in Chest.

Factors associated with worse quality of life at 3 and 12 months included preexisting chronic cardiopulmonary disease, female sex and elevated BMI.

“The application of [the Pulmonary Embolism Quality of Life questionnaire] in cross-sectional studies and prospective cohort studies of selected populations has generated the hypothesis that complete functional recovery, as reflected in several quality of life dimensions, may require several months, or possibly not occur at all, thus adding further support to the clinical and epidemiologic relevance of the ‘post-PE syndrome,’” Luca Valerio, MD, research associate and fellow in the Center for Thrombosis and Hemostasis at the University Medical Center of Johannes Gutenberg University in Mainz, Germany, and colleagues wrote. “However, to the best of our knowledge, neither the temporal course of quality of life and its individuals dimensions nor their association with baseline clinical characteristics have thus far been the object of investigation in prospectively studied large cohorts of survivors of acute PE.”

The researchers analyzed adults in the FOCUS study, which prospectively followed patients with objectively diagnosed acute PE. The analysis included 620 adults (mean age, 62 years; 44% women) who completed the Pulmonary Embolism Quality of Life questionnaire at visits 3 and 12 months after PE. Researchers assessed disease-specific quality of life, generic quality of life and the impact of baseline characteristics on quality of life.

From 3 to 12 months, overall disease-specific quality of life improved, with a decrease in median Pulmonary Embolism Quality of Life questionnaire score from 19.4% to 13% (mean individual change, –4.3% [95% CI, –3.2 to –5.5]). There was also an improvement in generic quality of life, with an increase from 0.85 to 0.87 in the EuroQoL Group 5-Dimension 5-level utility index and an improvement from 72.9 to 74.4 on the visual analog scale.

“Over time, the association with BMI became weaker, and quality of life declined in older patients and those with a history of [venous thromboembolism],” the researchers wrote.

“Our findings may have direct implications for clinical practice and future research,” the researchers wrote. “Following management decisions after risk stratification of acute PE, the first follow-up evaluation at 3 months represents a critical milestone for decisions regarding the duration of anticoagulation and possible additional testing for late sequelae of PE.”