Functional limitations 3 and 12 months after venous thromboembolism: a cohort study

IF 3.4 3区 医学 Q2 HEMATOLOGY
Daniel Steiner , Stephan Nopp , Georg Heinze , Daniel Kraemmer , Oliver Schlager , Stefano Barco , Frederikus A. Klok , Ingrid Pabinger , Benedikt Weber , Cihan Ay
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Abstract

Background

Venous thromboembolism (VTE) is associated with various long-term complications.

Objectives

We aimed to investigate the association of clinical characteristics at VTE diagnosis with functional limitations 3 and 12 months afterward.

Methods

We conducted a prospective cohort study of VTE patients, excluding patients with cancer, pregnancy, and postpartum period. Functional limitations were assessed with the post-VTE functional status (PVFS) scale (range, 0-4) within 21 days of diagnosis, after 3 and 12 months (prospectively), and 1 month before diagnosis (retrospectively). Twelve-month follow-up was only performed in patients on anticoagulation. We fitted 2 proportional odds logistic regression models for the 3- and 12-month follow-ups and computed odds ratios (ORs) with 95% bootstrap percentile confidence intervals (CIs).

Results

We included 307 patients (42% female, median age 55.6 years) with a median (IQR) PVFS scale grade of 2 (2-3) at study inclusion and 0 (0-0) before diagnosis. After 3 months, PVFS scale grade in 269 patients was 1 (0-2). Female sex (OR, 2.15; 95% CI, 1.26-4.14), body mass index (OR per 1 kg/m2 increase, 1.05; 95% CI, 1.00-1.10), functional limitations at baseline, and older age were associated with functional limitations. After 12 months, PVFS scale grade in 124 patients was 1 (0-2). Female sex (OR, 4.47; 95% CI, 2.11-16.00), history of cardiovascular/pulmonary disease (OR, 2.36; 95% CI, 1.01-6.89), and functional limitations at baseline were associated with functional limitations.

Conclusion

Functional limitations in VTE patients improved 3 and 12 months after diagnosis but did not return to pre-VTE values. We identified clinical characteristics that could help identify patients at risk of persisting functional limitations after VTE.

Abstract Image

静脉血栓栓塞症 3 个月和 12 个月后的功能限制:一项队列研究
背景静脉血栓栓塞症(VTE)与各种长期并发症相关。目的我们旨在研究 VTE 诊断时的临床特征与诊断后 3 个月和 12 个月的功能限制之间的关系。方法我们对 VTE 患者进行了前瞻性队列研究,排除了癌症、妊娠和产后患者。在确诊后 21 天内、3 个月后和 12 个月后(前瞻性)以及确诊前 1 个月(回顾性),我们使用 VTE 后功能状态(PVFS)量表(范围 0-4)对患者的功能限制进行了评估。仅对接受抗凝治疗的患者进行了 12 个月的随访。我们为 3 个月和 12 个月的随访建立了 2 个比例赔率逻辑回归模型,并计算了赔率比(OR)和 95% 引导百分位数置信区间(CI)。结果我们纳入了 307 名患者(42% 为女性,中位年龄为 55.6 岁),研究纳入时的 PVFS 量表分级中位数(IQR)为 2(2-3),诊断前为 0(0-0)。3 个月后,269 名患者的 PVFS 评分为 1(0-2)。女性性别(OR,2.15;95% CI,1.26-4.14)、体重指数(每增加 1 kg/m2 的 OR,1.05;95% CI,1.00-1.10)、基线时的功能限制和年龄较大与功能限制有关。12 个月后,124 名患者的 PVFS 量表等级为 1(0-2)。女性(OR,4.47;95% CI,2.11-16.00)、心血管/肺部疾病史(OR,2.36;95% CI,1.01-6.89)和基线时的功能限制与功能限制有关。我们发现了一些临床特征,这些特征有助于识别VTE后有持续功能受限风险的患者。
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来源期刊
CiteScore
5.60
自引率
13.00%
发文量
212
审稿时长
7 weeks
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