Determinants of Quality of Life in Patients with Post-Thrombotic Syndrome

Abstract

Chronic post-thrombotic syndrome (PTS) may develop in up to 50% of patients after deep vein thrombosis (DVT), and may reduce patients' quality of life (QoL). We aimed to evaluate the association of PTS severity with QoL in patients with proximal DVT submitted for medical treatment and also to identify modifiable and non-modifiable risk factors related to PTS. Patients with iliac or femoropopliteal DVT observed in Vascular Surgery consultation in our institution from 1year period with unilateral DVT were selected. Patients with total vein recanalization were excluded. Villalta scale was applied to assess PTS degree and VEINES-QoL/Sym questionnaire was used as a disease-specific QoL measure. Correlation between PTS degree and VEINES-QoL/Sym score and predictors of PTS were determined. Fifty-six patients were accepted to enter the study. From those, 66.1% were female, 64.3% (n=36) had iliac and 35.7% (n=20) femoropopliteal DVT. PTS was present in 52.8% of iliac and 65.0% of femoropopliteal DVT patients observed for consultation (P=0.41). There was a significant correlation with PTS degree and both VEINES-QoL and VEINES-Sym scores (P<0.01). Major depression (odds ratio OR=5.63, P=0.04) and regular wear of compressing stockings (OR=4.69, P=0.04) were the only independent factors associated with PTS. Patients with depression had lower QoL scores, while patients with PTS who wear compression stockings had similar QoL scores compared to patients without PTS. Ultrasound alterations (OR=3.28, P=0.17), age, gender, iliac DVT, multiple DVT and time after DVT (P>0.20) were not associated with PTS syndrome. VEINES-QoL/Sym had moderate inverse correlation with PTS degree. Depression was associated with both PTS and lower QoL scores. Patients with PTS criteria compliant to wearing compressing stockings had similar QoL scores to patients without PTS.