Health-related quality of life (QoL) impairment is common after pulmonary embolism (PE). Whether severity of the initial PE has an impact on QoL is unknown.
To evaluate the association between severity of PE and QoL over time.
We prospectively assessed PE-specific QoL using the Pulmonary Embolism Quality of Life (PEmb-QoL; lower scores indicate better QoL) and generic QoL using the Short Form 36 (SF-36; higher scores indicate better QoL) questionnaire at baseline, 3, and 12 months in older patients with acute PE. We examined whether QoL differed by PE severity based on hemodynamic status, simplified Pulmonary Embolism Severity Index (sPESI), right-ventricular function, and high-sensitivity (hs)-troponin T in mixed-effects models, adjusting for known QoL predictors after PE.
Among 546 patients with PE (median age 74 years), severe vs. non-severe PE based on the sPESI was associated with a worse PE-specific (adjusted mean PEmb-QoL score difference of 6.1 [95%CI 2.4;9.8] at baseline, 7.6 [95%CI 4.0;11.3] at 3 months, and 6.7 [95%CI 2.9;10.4] at 12 months) and physical generic QoL (adjusted mean SF-36 Physical Component Summary score difference -3.8 [95%CI -5.5;-2.1] at baseline; -4.8 [95%CI -6.4;-3.1] at 3 months; -4.1 [95%CI -5.8;-2.3] at 12 months). Elevated troponin was also associated with lower PE-specific QoL at 3 and physical generic QoL at 3 and 12 months. QoL did not differ by hemodynamic status or right-ventricular function.
Severe PE based on the sPESI was consistently associated with worse PE-specific and physical generic QoL over time as compared to non-severe PE.