Pulmonary embolism caused a moderate, lasting reduction in quality of life, with HrQoL index decreases of -0.04 at 3 months and -0.02 at 12 months post-PE.
Does acute pulmonary embolism reduce long-term health-related quality of life compared to a matched general population?
Acute pulmonary embolism is independently associated with a moderate, persistent decrease in health-related quality of life up to 12 months post-event, with an estimated annual disability weight of 0.03.
Absolute Event Rate: 0% vs 0%
Abstract Background Functional limitations and persisting complaints characterize the long-term clinical course of survivors of acute pulmonary embolism (PE), contributing to a substantial disease burden for both patients and healthcare systems. However, existing evidence on how much PE reduces quality of life is sparse and mostly derived from studies of PE survivors, with no direct comparison with individuals from a reference population and no consideration of the impact of potential confounders. An estimate of the reduction in quality of life imposed by PE would serve as reference for interventional studies and as basis for the first estimation of quality- and disability-adjusted life years (QALYs and DALYs) for PE. Purpose To quantify the impact of PE on health-related quality of life (HrQoL) in the year following the acute event, and estimate a corresponding QALY weight and DALY weight, in a matched cohort study comparing prospectively followed patients to control individuals with a similar demographic and comorbidity profile from the general population. Methods A total of 1005 patients from a prospective German multicenter study, followed 3 and 12 months after PE, were successfully matched to 3058 individuals from the general population of the same country based on age, sex, and key comorbidities (Table 1). HrQoL was assessed using the EQ-5D-5L instrument. Differences in the five EQ-5D-5L ordinal dimensions were analyzed using multivariable ordinal regression, in the EQ-5D-5L HrQoL index (reflecting overall HrQoL) using multivariable-adjusted mixed linear regression. Both multiple imputation and complete case analyses were performed. Results Compared to controls, PE survivors reported worse HrQoL in the dimensions self-care, usual activities, and anxiety/depression, and worse HrQoL index at both 3 (adjusted difference -0.04 95% CI: -0.06, -0.039 in a range from 0 to 1) and 12 months (-0.02 95% CI: -0.04, -0.01) in the imputation analysis. Pain/discomfort was more pronounced early after PE but diminished over time, whereas mobility remained unaffected (Figure 1). The impairment was independent of age, sex, or other coexisting health conditions. Complete case analysis yielded similar results. The annual disability (DALY) weight of PE was conservatively estimated at 0.03 (95% CI: 0.02, 0.04). Conclusions PE was independently associated with a moderate decrease in HrQoL, which persisted 12 months after the acute episode despite partial recovery over time. The magnitude of impairment was similar to that of other cardiopulmonary diseases. These results highlight the long-term consequences of PE and emphasize the need to account for its lasting impact in population-level disease burden assessments, primary prevention strategies, and evaluations of interventions aimed at improving outcomes in PE survivors.
Valerio et al. (Sat,) reported a other. Pulmonary embolism caused a moderate, lasting reduction in quality of life, with HrQoL index decreases of -0.04 at 3 months and -0.02 at 12 months post-PE.