title: Quality of life in long-term survivors of acute pulmonary embolism.
abstract: BACKGROUND
  To our knowledge, studies evaluating the quality of life (QoL) in patients with a history of acute pulmonary embolism (PE) are not available, even though QoL is a key outcome component of medical care and a predictor of disease-specific prognosis.
  
  
  METHODS
  As part of a large follow-up study, the Short Form 36 (SF-36) was presented to consecutive patients who had survived one or more episodes of acute PE. The results of all nine subscales of the SF-36 were compared with sex- and age-adjusted Dutch population norms. Single and multivariate analyses were performed to identify independent determinants of the QoL in our study population.
  
  
  RESULTS
  The SF-36 was completed by 392 patients. Except for the health change subscale, patients had substantially lower QoL than population norms on all eight remaining subscales. After multivariate analysis, the time interval between the last thromboembolic episode and study inclusion was inversely related to QoL, and significant determinants of poor QoL were prior PE, age, obesity, active malignancy, and cardiopulmonary comorbid conditions. Regression models that included all identified significant determinants proved to be quite modest predictors for QoL in the individual patient. Awareness of illness, coping mechanisms, and self-management behavior might be additional important indicators of QoL in our study population but require further investigation.
  
  
  CONCLUSIONS
  We identified several PE- and non-PE-related determinants of QoL in patients with a history of acute PE, which is impaired compared with sex- and age-adjusted population norms. QoL after acute PE should be studied more extensively and added as a standard measure to outcome studies.
authors.affiliation: Leiden University Medical Center (C4-70), Leiden, The Netherlands. F.A.Klok@LUMC.nl
authors.forename: Frederikus A
authors.initials: FA
authors.lastname: Klok
authors.forename: Klaas W
authors.initials: KW
authors.lastname: van Kralingen
authors.forename: Arie P J
authors.initials: AP
authors.lastname: van Dijk
authors.forename: Fenna H
authors.initials: FH
authors.lastname: Heyning
authors.forename: Hubert W
authors.initials: HW
authors.lastname: Vliegen
authors.forename: Ad A
authors.initials: AA
authors.lastname: Kaptein
authors.forename: Menno V
authors.initials: MV
authors.lastname: Huisman
mesh_terms: D000208:Acute Disease; D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011594:Psychometrics; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000401:mortality / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life; D012008:Recurrence; D012648:Self Care; D012737:Sex Factors; D018434:Sickness Impact Profile; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013997:Time Factors