title: What is the effect of venous thromboembolism and related complications on patient reported health-related quality of life? A meta-analysis.
abstract: We conducted a meta-analysis of the literature to 1) assess the health-related quality of life for patients with a minimum follow-up of one year after an episode of pulmonary embolism (PE) or deep-vein thrombosis (DVT), and 2) to assess the HRQOL for patients who develop chronic thromboembolic pulmonary hypertension (CTEPH) and post thrombotic syndrome (PTS). PubMed, EMBASE, and the Cochrane Library were searched from inception to March 30, 2016. Data were pooled using random-effects meta-analysis, and heterogeneity was assessed with I² and Tau² tests. SF-12, SF-36, and VEINES-QOL were evaluated with pooled standardised mean difference (SMD) and 95 % confidence intervals (CI). Fourteen studies were included for meta-analysis. In patients who sustain a PE, physical health becomes impaired (p<0.001, 2 studies) but mental health appears to remain similar to population norms (p=0.069, 2 studies) after at least one year. Patients who develop CTEPH report worse physical (p<0.001, 1 study) and mental health (p=0.009, 1 study). In patients who suffer from a DVT, physical health (p=0.19, 9 studies), mental health (p=0.67, 9 studies), and disease specific quality of life (p=0.61, 8 studies) remain similar to population norms after at least one year. Patients who develop PTS, however, report worse physical health (p<0.001, 7 studies), mental health (p<0.001, 7 studies), and disease specific quality of life (p<0.001, 10 studies). These data can be used to educate patients during the shared decision making process that increasingly governs medical care today.
  
  
  
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authors.affiliation: Bart Lubberts, MD, Orthopaedic Foot and Ankle Service, Massachusetts General Hospital - Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA, Tel.: +1 857 389 2495, E-mail: blubberts@partners.org.
authors.forename: Bart
authors.initials: B
authors.lastname: Lubberts
authors.forename: Nuno Rui
authors.initials: NR
authors.lastname: Paulino Pereira
authors.forename: Christopher
authors.initials: C
authors.lastname: Kabrhel
authors.forename: David J
authors.initials: DJ
authors.lastname: Kuter
authors.forename: Christopher W
authors.initials: CW
authors.lastname: DiGiovanni
mesh_terms: D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D054070:Postthrombotic Syndrome / Q000209:etiology; D011655:Pulmonary Embolism / Q000150:complications; D011788:Quality of Life; D054556:Venous Thromboembolism / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D020246:Venous Thrombosis / Q000150:complications
keywords: Quality of life; chronic thromboembolic pulmonary hypertension; meta-analysis; post-thrombotic syndrome; venous thromboembolism