DVT and Quality of Life Issues

DVT patients treated with anticoagulation have lower quality of life scores than the unafflicted population; their quality of life akin to those suffering from angina, arthritis and chronic lung disease.

The quality of life of a substantial set of DVT patients worsens over time though treated with anticoagulation.

A multi-center prospective trial of 359 patients with confirmed DVT was undertaken to measure quality of life (QOL) in a longitudinal manner. Validated generic (SF-36) and disease specific (VEINES) questionnaires were administered to patients at diagnosis, 1 and 4 months follow-up. A clinically validated method of determining the signs and symptoms of Post-thrombotic Syndrome (PTS) was used at each time period. Subcutaneous low molecular weight heparin was given for 5-10 days to all patients and oral warfarin was continued by 93.8% of patients at 1 month follow-up and 36.7 % at 4 month follow-up.

During the 4 month follow-up, average scores improved for both the generic SF-36 and VEINES QOL measures. One third of patients showed a worsening of scores for the follow-up period. Worsening of the PTS score was highly correlated with worsening of the physical component of the VEINES and SF-36 scores. At all time periods, the physical component of the SF-36 QOL scores was lower than general population norms.
Reference: Kahn, SR, Ducret, T, Lamping, DL, et al. Prospective Evaluation of Health-Related Quality of Life in Patients with Deep Venous Thrombosis. Arch Intern Med 2005; 165:1173-1178.

Key Learnings:

  • QOL scores for DVT patients at one month were lower than patients with chronic lung disease and arthritis and similar to patients with angina
  • QOL scores for DVT patients at four months were similar to patients with chronic lung disease and arthritis
  • QOL scores for DVT patients were substantially lower than general population norms for all time periods
  • Worsening of the PTS score during the 4 month follow-up occurred in 48.4% of the patients
  • QOL scores were lower for those patients with proximal DVT than patients with distal DVT