Anxiety in patients with venous thromboembolism: Quantification and risk factors in a prospective cohort study.

anxiety mental health psychosocial care pulmonary embolism venous thromboembolism venous thrombosis

Journal

Journal of thrombosis and haemostasis : JTH
ISSN: 1538-7836
Titre abrégé: J Thromb Haemost
Pays: England
ID NLM: 101170508

Informations de publication

Date de publication:
07 Aug 2024
Historique:
received: 21 05 2024
revised: 05 07 2024
accepted: 08 07 2024
medline: 10 8 2024
pubmed: 10 8 2024
entrez: 9 8 2024
Statut: aheadofprint

Résumé

Patients with venous thromboembolism (VTE) are at risk for psychological consequences. However, as opposed to physical sequelae of VTE, mental health issues are understudied. To assess anxiety after VTE and investigate associated clinical characteristics. We conducted a prospective cohort study, including patients with acute deep vein thrombosis (DVT) and/or pulmonary embolism (PE). Patients with cancer, pregnancy, or puerperium were excluded. Anxiety was assessed with the PROMIS short form 8a. Standardized T-scores were calculated (reference: 50, SD 10), with higher values indicating more anxiety. We associated clinical characteristics at baseline with T-scores at three-month follow-up in a multivariable linear regression model. Patient clusters depending on anxiety trajectories were explored. We included 257 patients (38.5% women) with a median (IQR) age of 54.1 (42.2-63.5) years. While mean (SD) T-scores decreased from baseline to follow-up (51.03 (9.18) to 46.74 (8.89), p<0.001), we observed an increase in 23.7%. Female sex (T-score change: 3.09, 95% confidence interval (CI), 0.96-5.22), older age until 45 years, and anxiety at baseline were associated with increased T-scores at follow-up. VTE history (-1.55, 95%CI, -3.62 to 0.52) and PE (-1.23, 95%CI, -3.16 to 0.69) were associated with reduced T-scores, albeit not reaching statistical significance. In a cluster of older, female patients with DVT, anxiety tended to increase over time. While most patients with VTE reported reduced anxiety over time, some patients experienced worsening. Female sex, older age, more anxiety at baseline, no VTE history, and DVT were associated with increased anxiety three months after VTE.

Sections du résumé

BACKGROUND BACKGROUND
Patients with venous thromboembolism (VTE) are at risk for psychological consequences. However, as opposed to physical sequelae of VTE, mental health issues are understudied.
OBJECTIVES OBJECTIVE
To assess anxiety after VTE and investigate associated clinical characteristics.
PATIENTS/METHODS METHODS
We conducted a prospective cohort study, including patients with acute deep vein thrombosis (DVT) and/or pulmonary embolism (PE). Patients with cancer, pregnancy, or puerperium were excluded. Anxiety was assessed with the PROMIS short form 8a. Standardized T-scores were calculated (reference: 50, SD 10), with higher values indicating more anxiety. We associated clinical characteristics at baseline with T-scores at three-month follow-up in a multivariable linear regression model. Patient clusters depending on anxiety trajectories were explored.
RESULTS RESULTS
We included 257 patients (38.5% women) with a median (IQR) age of 54.1 (42.2-63.5) years. While mean (SD) T-scores decreased from baseline to follow-up (51.03 (9.18) to 46.74 (8.89), p<0.001), we observed an increase in 23.7%. Female sex (T-score change: 3.09, 95% confidence interval (CI), 0.96-5.22), older age until 45 years, and anxiety at baseline were associated with increased T-scores at follow-up. VTE history (-1.55, 95%CI, -3.62 to 0.52) and PE (-1.23, 95%CI, -3.16 to 0.69) were associated with reduced T-scores, albeit not reaching statistical significance. In a cluster of older, female patients with DVT, anxiety tended to increase over time.
CONCLUSIONS CONCLUSIONS
While most patients with VTE reported reduced anxiety over time, some patients experienced worsening. Female sex, older age, more anxiety at baseline, no VTE history, and DVT were associated with increased anxiety three months after VTE.

Identifiants

pubmed: 39122191
pii: S1538-7836(24)00433-1
doi: 10.1016/j.jtha.2024.07.016
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Daniel Steiner (D)

Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.

Stephan Nopp (S)

Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.

Timothy Hoberstorfer (T)

Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.

Ingrid Pabinger (I)

Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.

Benedikt Weber (B)

Department of Dermatology, Medical University of Vienna, Vienna, Austria.

Cihan Ay (C)

Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria. Electronic address: cihan.ay@meduniwien.ac.at.

Classifications MeSH