Long-term Outcomes of Deep-Vein Thrombosis

OBJECTIVE: To assess the long-term outcomes of patients with acute deep-vein thrombosis. METHODS: We followed up 124 patients with deep-vein thrombosis 6 to 8 years after the index thrombosis to determine the frequency of death, recurrent venous thromboembolism, postphlebitic symptoms, and their relationship to three domains of health-related quality of life. RESULTS: Fifty-two (42%) of the 124 patients died. The cumulative incidence of death was 17% at 1 year and 39% at 5 years. Death was especially common among patients older than 75 years and those with cancer or stroke (5-year cumulative incidence, 66%, compared with 12% among other patients; P < .0001). Most deaths were attributable to cancer or cardiovascular disease. Venous thromboembolism recurred in 18 patients (15%); the cumulative incidence was 6% at 1 year and 13% at 5 years. Recurrence was more common, however, among patients younger than 65 years with a history of recurrent venous thromboembolism (5-year cumulative incidence, 34%, compared with 10% among other patients; P < .01). In interviews with 52 patients 6 to 8 years after the index deep-vein thrombosis, 42% reported pain, swelling, or discoloration in the leg affected by the index thrombosis. Perceptions of health, physical functioning, and role limitations attributed to physical health were worse (P < .01 for each domain) in symptomatic patients than in asymptomatic patients. CONCLUSIONS: Six to 8 years after deep-vein thrombosis, many patients had died of preexisting cancer or cardiovascular disease. Recurrent venous thromboembolism was uncommon. Symptoms in the leg affected by the index thrombosis were common, however, and were associated with worse health-related quality of life.