自我报告的种族对 Villalta 量表血栓后综合征评分的影响以及与静脉疾病生活质量的相关性：急性静脉血栓形成：急性静脉血栓形成：辅助导管定向溶栓的血栓清除试验的探索性分析

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis Pub Date : 2024-11-01 DOI:10.1016/j.rpth.2024.102609

James Shih MD , Chu-Shu Gu PhD , Suresh Vedantham MD , John Kaufman MD , Susan R. Kahn MD

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引用次数: 0

摘要

背景诊断血栓后综合征（PTS）的 Villalta 量表（VS）由患者报告的 5 个腿部症状和临床医生评定的 6 个腿部体征组成。方法对 ATTRACT 试验进行探索性分析，该试验是一项随机对照试验，在美国 56 个地点进行，研究了药物机械导管引导溶栓以预防近端深静脉血栓 (DVT) 后的 PTS。在随机化后 6 个月的回访中，我们比较了黑人（n = 123）和白人（n = 541）参与者自我报告的平均 VS 总分、VS 症状分、VS 体征分、单个体征分、VS 体征与 VS 症状分之间的相关系数以及 VS 体征与静脉功能不全流行病学和经济学生活质量研究 (VEINES-QOL) 分（一种自我报告的静脉疾病特异性生活质量测量指标）之间的相关系数。结果黑人和白人参与者的平均 VS 总分（4.67 vs. 4.12，P = .54）、VS 体征得分（1.66 vs. 2.00，P = .07）和 VS 症状得分（2.83 vs. 2.04，P = .10）相似。黑人和白人参加者在静脉异位这一 VS 征兆上的平均得分较低（0.24 vs. 0.63，P< .01）。在黑人和白人参与者中，VS 征兆和 VS 症状评分之间（黑人 = 0.19；白人 = 0.23）以及 VS 征兆和 VEINES-QOL 评分之间（黑人 = -0.32；白人 = -0.30）存在类似的适度相关性。结果根据 ATTRACT 试验治疗组、年龄、性别、体重指数、深静脉血栓程度、高血压、糖尿病、血脂异常和充血性心力衰竭进行了调整。目前还不清楚这是否反映了临床医生对某些 VS 征兆的低估和/或 PTS 严重程度的差异。要了解 VS 在不同种族群体中的表现，还需要进一步的研究。

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Impact of self-reported race on Villalta Scale postthrombotic syndrome scores and correlation with venous disease-specific quality of life: an exploratory analysis of the Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis Trial

Background

The Villalta Scale (VS) to diagnose postthrombotic syndrome (PTS) consists of 5 patient-reported leg symptoms and 6 clinician-rated leg signs. It is unknown how the scale performs across racial groups.

Objectives

Our study explored if there were differences in VS scores, particularly clinician-rated signs components, according to self-reported race.

Methods

Exploratory analysis of the ATTRACT trial, a randomized controlled trial conducted at 56 US sites that investigated pharmacomechanical catheter-directed thrombolysis to prevent PTS after proximal deep vein thrombosis (DVT). At the 6-month visit after randomization, we compared self-reported Black (n = 123) and White (n = 541) participants for mean total VS score, VS symptoms score, VS signs score, individual signs scores, and correlation coefficients between VS signs and VS symptoms scores and between VS signs and Venous Insufficiency Epidemiological and Economic Study Quality of Life (VEINES-QOL) scores (a self-reported venous disease-specific quality of life measure).

Results

Mean total VS score (4.67 vs. 4.12, P = .54),VS signs score (1.66 vs. 2.00, P = .07), and VS symptoms score (2.83 vs. 2.04, P = .10) were similar between Black and White participants. The mean score for one individual VS sign, venous ectasia, was lower in Black vs. White participants (0.24 vs. 0.63, P< .01). There was similar, modest correlation in Black and White participants between VS signs and VS symptoms scores (r_black = 0.19; r_white = 0.23) and between VS signs and VEINES-QOL scores (r_black = −0.32; r_white = −0.30). Results were adjusted for ATTRACT trial treatment group, age, sex, body mass index, DVT extent, hypertension, diabetes, dyslipidemia, and congestive heart failure.

Conclusion

The findings suggest that some differences in VS scores exist according to self-reported race. It is unclear whether these reflect clinicians’ underrating of some VS signs and/or differences in PTS severity. Further work is needed to understand how the VS performs across racial groups.

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