Walking capacity and venous claudication after deep vein thrombosis: prospective follow-up, risk factors, and quality of life.

Abstract

Introduction: Data on the course of walking capacity after acute DVT are scarce. The aim of this prospective observational study was to assess the course of walking impairment and venous claudication after DVT and the association with clinical characteristics and quality of life (QoL).

Materials and methods: Walking capacity was assessed by standardized treadmill exercise tests (TET) at DVT diagnosis and after three months. Pain-free walking distance (PWD) and maximum walking distance (MWD) were recorded. Venous claudication during TET was evaluated and documented by trained biomedical scientists according to a standardized protocol. QoL was evaluated with the EQ-5D-5L and the VEINES-QOL/Sym questionnaires.

Results: Seventy-three patients (30.1% women, median age 53.8, IQR: 42.9-60.0 years) were included. PWD and MWD generally improved over time with a median change of 305 (IQR: 33-710) and 30 (IQR: 0-258) meters, respectively. However, 16 (28.1%) patients reported persistent venous claudication after three months. Patients with venous claudication after three months tended to have higher rates of suprainguinal DVT, higher BMI, higher rates of arterial hypertension, and were admitted to the hospital at DVT diagnosis more often. Generic and disease-specific QoL improved overall, but patients with venous claudication had significantly lower QoL scores than those without.

Conclusions: Walking capacity generally improved after DVT, but about one third of patients had persisting venous claudication after three months, which was associated with poorer QoL. Suprainguinal DVT, higher BMI, arterial hypertension, and hospital admission at diagnosis were more common in patients with venous claudication three months after DVT.