肺栓塞
医学
内科学
肌钙蛋白
生活质量(医疗保健)
疾病严重程度
物理疗法
心脏病学
心肌梗塞
护理部
作者
Ursula Magyar,Odile Stalder,Christine Baumgartner,Marie Méan,Marc Righini,Philipp Schüetz,Stefano Bassetti,Nicolas Rodondi,Tobias Tritschler,Drahomir Aujesky
标识
DOI:10.1016/j.jtha.2023.10.016
摘要
BackgroundHealth-related quality of life (QoL) impairment is common after pulmonary embolism (PE). Whether the severity of the initial PE has an impact on QoL is unknown.ObjectivesTo evaluate the association between severity of PE and QoL over time.MethodsWe prospectively assessed PE-specific QoL using the Pulmonary Embolism Quality of Life (lower scores indicate better QoL) questionnaire and generic QoL using the Short Form 36 (higher scores indicate better QoL) questionnaire at baseline and 3 and 12 months in older patients with acute PE. We examined whether QoL differed by PE severity based on hemodynamic status, simplified Pulmonary Embolism Severity Index (sPESI), right ventricular function, and high-sensitivity troponin T in mixed-effects models, adjusting for known QoL predictors after PE.ResultsAmong 546 patients with PE (median age, 74 years), severe vs nonsevere PE based on the sPESI was associated with a worse PE-specific (adjusted mean Pulmonary Embolism Quality of Life score difference of 6.1 [95% CI, 2.4-9.8] at baseline, 7.6 [95% CI, 4.0-11.3] at 3 months, and 6.7 [95% CI, 2.9-10.4] at 12 months) and physical generic QoL (adjusted mean Short Form 36 Physical Component Summary score difference of −3.8 [95% CI, −5.5 to −2.1] at baseline, −4.8 [95% CI, −6.4 to −3.1] at 3 months, and −4.1 [95% CI, −5.8 to −2.3] at 12 months). Elevated troponin levels were also associated with lower PE-specific QoL at 3 months and lower physical generic QoL at 3 and 12 months. QoL did not differ by hemodynamic status or right ventricular function.ConclusionSevere PE based on the sPESI was consistently associated with worse PE-specific and physical generic QoL over time as compared to nonsevere PE.
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