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Long-term outcomes after deep vein thrombosis: Postphlebitic syndrome and quality of life

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Abstract

In this review, we critically assess the literature on the incidence of postphlebitic syndrome, risk factors for its occurrence, available therapeutic options, and its effects on quality of life. As well, we describe available tools to measure postphlebitic syndrome. Recent prospective studies indicate that postphlebitic syndrome, a chronic, potentially disabling condition characterized by leg swelling, pain, venous ectasia, and skin induration, is established by 1 year after deep vein thrombosis (DVT) in 17% to 50% of patients. The only prospectively identified risk factor for its occurrence is recurrent ipsilateral DVT. In the sole randomized study available, daily use of elastic compression stockings after proximal DVT reduced the incidence of postphlebitic syndrome by 50%. Treatment options for established postphlebitic syndrome are limited, but include compression stockings and intermittent compressive therapy with an extremity pump for severe cases. To date, quality of life after DVT has received little attention in the literature. The recent development of the VEINES-QOL questionnaire, a validated venous-disease-specific measure of quality of life, should encourage researchers to include quality of life as a routine outcome measure after DVT. There is no criterion standard for the diagnosis of postphlebitic syndrome, but a validated clinical scoring system does exist. More research on postphlebitic syndrome is needed to enable us to provide DVT patients with comprehensive, evidence-based information regarding their long-term prognosis, to help quantify the prevalence and health care burden of postphlebitic syndrome, and by identifying predictors of poor outcome, to develop new preventive strategies in patients at risk of developing this condition.

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Authors and Affiliations

  1. Center for Clinical Epidemiology and Community Studies, Sir Mortimer B. Davis Jewish General Hospital, 3755 Cote Ste Catherine Road, Rm. A-127, H3T 1E2, Montreal, Quebec, Canada

    Susan R. Kahn MD, MSc & Lucien Abenhaim MD, ScD

  2. Division of Hematology, Montreal General Hospital, Montreal, Canada

    Susan Solymoss MD

  3. Health Services Research Unit, London School of Hygiene and Tropical Medicine, London, U.K.

    Donna L. Lamping PhD

Authors
  1. Susan R. Kahn MD, MSc
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  2. Susan Solymoss MD
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  3. Donna L. Lamping PhD
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  4. Lucien Abenhaim MD, ScD
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Correspondence to Susan R. Kahn MD, MSc.

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Kahn, S.R., Solymoss, S., Lamping, D.L. et al. Long-term outcomes after deep vein thrombosis: Postphlebitic syndrome and quality of life. J GEN INTERN MED 15, 425–429 (2000). https://doi.org/10.1046/j.1525-1497.2000.06419.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.2000.06419.x

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