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. 2024 May 28;8(4):102464.
doi: 10.1016/j.rpth.2024.102464. eCollection 2024 May.

Functional limitations 3 and 12 months after venous thromboembolism: a cohort study

Daniel Steiner  1 , Stephan Nopp  1 , Georg Heinze  2 , Daniel Kraemmer  1 , Oliver Schlager  3 , Stefano Barco  4 , Frederikus A Klok  5 , Ingrid Pabinger  1 , Benedikt Weber  6 , Cihan Ay  1
Affiliations

Functional limitations 3 and 12 months after venous thromboembolism: a cohort study

Daniel Steiner et al. Res Pract Thromb Haemost. .

Abstract

Background: Venous thromboembolism (VTE) is associated with various long-term complications.

Objectives: We aimed to investigate the association of clinical characteristics at VTE diagnosis with functional limitations 3 and 12 months afterward.

Methods: We conducted a prospective cohort study of VTE patients, excluding patients with cancer, pregnancy, and postpartum period. Functional limitations were assessed with the post-VTE functional status (PVFS) scale (range, 0-4) within 21 days of diagnosis, after 3 and 12 months (prospectively), and 1 month before diagnosis (retrospectively). Twelve-month follow-up was only performed in patients on anticoagulation. We fitted 2 proportional odds logistic regression models for the 3- and 12-month follow-ups and computed odds ratios (ORs) with 95% bootstrap percentile confidence intervals (CIs).

Results: We included 307 patients (42% female, median age 55.6 years) with a median (IQR) PVFS scale grade of 2 (2-3) at study inclusion and 0 (0-0) before diagnosis. After 3 months, PVFS scale grade in 269 patients was 1 (0-2). Female sex (OR, 2.15; 95% CI, 1.26-4.14), body mass index (OR per 1 kg/m2 increase, 1.05; 95% CI, 1.00-1.10), functional limitations at baseline, and older age were associated with functional limitations. After 12 months, PVFS scale grade in 124 patients was 1 (0-2). Female sex (OR, 4.47; 95% CI, 2.11-16.00), history of cardiovascular/pulmonary disease (OR, 2.36; 95% CI, 1.01-6.89), and functional limitations at baseline were associated with functional limitations.

Conclusion: Functional limitations in VTE patients improved 3 and 12 months after diagnosis but did not return to pre-VTE values. We identified clinical characteristics that could help identify patients at risk of persisting functional limitations after VTE.

Keywords: deep vein thrombosis; functional status; patient-reported outcomes; post-VTE functional status scale; pulmonary embolism; venous thromboembolism.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Change in functional limitations from 1 month before venous thromboembolism diagnosis over the time of diagnosis to 3 months after the diagnosis. Alluvial plot showing absolute number of patients per category of functional limitations.
Figure 2
Figure 2
Partial effects plot of the log odds of age for having a higher post-VTE functional status (PVFS) scale grade 3 months after venous thromboembolism diagnosis. The depicted association refers to a patient of the female sex, body mass index of 28 kg/m2, pulmonary embolism, no major transient risk factor, no history of venous thromboembolism, no history of cardiovascular or pulmonary disease, nonsmoker, and PVFS scale grade of 2 at baseline. Each line on the bottom of the graph represents an individual patient, and longer lines represent 10th, 25th, 50th, 75th, and 90th percentile of age.
Figure 3
Figure 3
Change in functional limitations from 1 month before venous thromboembolism diagnosis over the time of diagnosis to 12 months after the diagnosis. Alluvial plot showing absolute number of patients per category of functional limitations.
See this image and copyright information in PMC

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