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. 2024 Jan 4:61:44-49.
doi: 10.1016/j.ejvsvf.2023.12.004. eCollection 2024.

Quality of Life After Early Clot Removal for Acute Iliofemoral Deep Vein Thrombosis

Jay M Bakas  1 , Catherine van Montfrans  2 , Adriaan Moelker  3 , Renate R van den Bos  2 , Wendy S J Malskat  2 , Hence J M Verhagen  1 , Marie Josee E van Rijn  1   2
Affiliations

Quality of Life After Early Clot Removal for Acute Iliofemoral Deep Vein Thrombosis

Jay M Bakas et al. EJVES Vasc Forum. .

Abstract

Objective: To evaluate patient reported outcome measures after early clot removal for acute deep vein thrombosis (DVT), using the Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20) and the Short Form Health Survey (SF-36).

Methods: Cross sectional design. Patients who underwent early clot removal between June 2012 and November 2021 were asked to complete the two questionnaires once. Lower CIVIQ-20 and higher SF-36 scores indicate better quality of life (QoL). Primary endpoints were the median scores. The one sample Wilcoxon signed rank test was used to compare SF-36 physical and mental component summary (PCS and MCS) to the normative and CIVIQ-20 to the minimum. Secondary, non-parametric independent t test or Fisher's exact test examined how age, sex, body mass index, stent placement, re-intervention, and time of questionnaire completion related to QoL. Multivariable linear regression tested whether various variables were associated with QoL.

Results: The response rate was 73.5% (n = 39). Median time of questionnaire completion was 1.8 years (interquartile range [IQR] 3.1) after clot removal. The median CIVIQ-20 of 29.0 (IQR 28.0) was slightly higher than the minimum value 20.0 (p < .001). The median PCS (50.5, IQR 16.6) and median MCS (50.2, IQR 14.2) did not differ from the normative of 50.0. However, wide IQRs indicated impairments for a subgroup of patients. None of the tested variables affected QoL except for the finding that re-interventions had a significantly negative impact on the SF-36 MCS (standardised β coefficient of -0.4, p = .030).

Conclusion: Overall patient reported outcome measures were satisfactory after early clot removal, but impaired physical and mental functioning levels were present in a subgroup of patients. Re-interventions were found to have a negative impact on mental QoL. This finding was independent of time that had passed between the procedure and questionnaire completion. This study emphasises that mental functioning deserves attention, besides the widely recognised physical consequences after invasive acute iliofemoral DVT treatment.

Keywords: Deep vein thrombosis: endovenous treatment; Mental health; Patient reported outcomes; Quality of life.

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Figures

Figure 1
Figure 1
Patient inclusion flowchart.
Figure 2
Figure 2
Total Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20) in all included patients. One sample Wilcoxon signed rank test to compare CIVIQ-20 with the minimum score of 20 indicated by the reference line.
Figure 3
Figure 3
Mental and physical component summaries (Short Form Health Survey [SF-36]) in all included patients. One sample Wilcoxon signed rank test comparing SF-36 scores to the normative value of 50.0 for general population (United States) indicated by the reference line.
See this image and copyright information in PMC

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