Functional limitations three and twelve months after venous thromboembolism: A cohort study

Background Venous thromboembolism (VTE) is associated with various long-term complications. We aimed to investigate the association of clinical characteristics at VTE diagnosis with functional limitations three and twelve months afterwards. Methods We conducted a prospective cohort study of VTE patients, excluding patients with cancer, pregnancy, and postpartum period. Functional limitations were assessed with the post-VTE functional status (PVFS) scale (range: 0-4) within 21 days of diagnosis, after three and twelve months (prospectively), and one month before diagnosis (retrospectively). Twelve-month follow-up was only performed in patients on anticoagulation. We fitted two proportional odds logistic regression models for the 3- and 12-month follow-ups and computed odds ratios (ORs) with 95% bootstrap percentile confidence intervals (CI). Results We included 307 patients (42% female, median age 55.6 years) with a median (interquartile range) PVFS scale grade of 2 (2-3) at study inclusion and 0 (0-0) before diagnosis. After three months, PVFS scale grade in 269 patients was 1 (0-2). Female sex (OR, 2.15, 95%CI, 1.26-4.14), BMI (OR per 1 kg/m2 increase: 1.05, 95%CI, 1.00-1.10), functional limitations at baseline, and older age were associated with functional limitations. After twelve months, PVFS scale grade in 124 patients was 1 (0-2). Female sex (OR, 4.47, 95%CI, 2.11-16.00), history of cardiovascular/pulmonary disease (OR, 2.36, 95%CI, 1.01-6.89), and functional limitations at baseline were associated with functional limitations. Conclusions Functional limitations in VTE patients improved three and twelve months after diagnosis, but did not return to pre-VTE values. We identified clinical characteristics which could help identifying patients at risk of persisting functional limitations after VTE.