QUALITY OF LIFE IN PATIENTS AFTER MASSIVE PULMONARY EMBOLISM

Abstract

Background. Pulmonary embolism is a disease, which has a 30% mortality if untreated, while an early diagnosis and treatment lowers it to 2–8%. Health related quality of life (HRQL) of patients who survived massive pulmonary embolism is unknown in published literature. In our research we tried to apply experience of foreign experts in estimation of quality of life in some other diseases to the field of massive pulmonary embolism. Patients and methods. Eighteen patients with shock or hypotension due to massive pulmonary embolism, treated with thrombolysis, between July 1993 and November 2000, were prospectively included in the study. Control group included 18 gender and age matched persons. There were no significant differences regarding demographic data between the groups. The HRQL and aerobic capacity of patients and control group were tested with short questions and questionnaires (Veterans brief, self administered questionnaire (VSAQ), EuroQuality questionnaire (EQ), Living with heart failure questionnaire (LlhHF). With LlhHF physical (F-LlhHF) and emotional (E-LlhHF) HRQL was assessed at hospitalization and 12 months later. Results. One year after massive pulmonary embolism aerobic capacity (–9.5%, p < 0.017) and HRQL (EQ (–34.5%), F-LlhHF (–85.4%), E-LlhHF (–48.7%)) decreased in massive pulmonary embolism group compared to aerobic capacity 6 months before massive pulmonary embolism and HRQL. Heart rate before thrombolysis correlated with aerobic capacity (r = 0.627, p < 0.01), EQ (r = 0.479, p < 0.01) and F-LlhHF (r = 0.479, p = 0.04) 1 year after massive pulmonary embolism. Total pulmonary resistance at 12 hours after start of treatment correlated with aerobic capacity at 1 year (r = 0.354, p < 0.01). With short question (»Did you need any help in everyday activities in last 2 weeks?«) we successfully separated patients with decreased HRQL in EQ (74.3 ± 20.8 vs. 24.5 ± 20.7, p < 0.001) and F-LlhHF (21.7 ± 6.7 vs. 32.8 ± 4.3, p < 0.01), but we could not identify the patients with deminished aerobic capacity. Conclusions. Aerobic capacity, emotional and physical quality of life is decreased one year after massive pulmonary embolism in patients treated with thrombolysis. A linear correlation between decrease in aerobic capacity and total pulmonary resistance after 12 hours of treatment was present.