Quality of life three and twelve months after acute pulmonary embolism: analysis from a prospective multicenter cohort study

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Background

Few data are available on the long-term course and predictors of quality of life (QoL) after acute pulmonary embolism (PE).

Research question

What are the kinetics and determinants of disease-specific and generic health-related QoL 3 and 12 months after acute PE?

Study design and methods

The FOllow-up after aCUte pulmonary emboliSm (FOCUS) study prospectively followed consecutive adult patients with objectively diagnosed PE. We considered patients who completed the Pulmonary Embolism QoL (PEmb-QoL) Questionnaire at predefined visits 3 and 12 months after PE. We studied the course of disease-specific QoL as assessed by PEmb-QoL and the impact of baseline characteristics using multivariable mixed-effects linear regression, along with the course of generic QoL as assessed by the EQ-5D-5L utility index and Visual Analogue Scale (VAS).

Results

In 620 patients (44% women, median age 62 years), overall disease-specific QoL improved from 3 to 12 months, with a decrease of the median PEmb-QoL score from 19.4% to 13.0% and a mean individual change of -4.3% (95% CI: -3.2% to -5.5%). Female sex, cardiopulmonary disease, and higher body-mass index were associated with worse QoL at both 3 and 12 months. Over time, the association with body-mass index became weaker, while older age and previous venous thromboembolism were associated with worsening QoL. Generic QoL also improved: the mean EQ-5D-5L utility index increased from 0.85 (standard deviation (SD) 0.22) to 0.87 (SD 0.20), the VAS from 72.9 (SD 18.8) to 74.4 (SD 19.1).

Interpretation

In a large cohort of survivors of acute PE, we quantified the change of QoL between months 3 and 12 after diagnosis, and identified factors independently associated with lower QoL and slower recovery of QoL. This information may facilitate the planning and interpretation of clinical trials assessing QoL and help guide patient management.



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