Aims: It has not been conclusively established whether and to what extent pulmonary embolism (PE) affects health-related quality of life (HrQoL). We aimed to assess the long-term independent association of PE with HrQoL to provide reference values for interventional studies and support quantification of the burden of PE in terms of quality- or disability-adjusted life years (QALYs and DALYs).
Methods: A total of 1005 patients from a prospective multicenter study, followed 3 and 12 months after PE, were successfully matched to 3058 individuals from the general population of the same country based on age, sex, and key comorbidities. Differences between acute PE survivors and matched controls in the ordinal EQ-5D-5L HrQoL dimensions were assessed using multivariable ordinal regression, in the HrQoL index (reflecting overall HrQoL) using multivariable-adjusted mixed linear regression. Both multiple imputation and complete case analysis were performed.
Results: Compared with controls, patients reported worse HrQoL in the dimensions self-care, usual activities, and anxiety/depression, and worse HrQoL index at both 3 (adjusted difference -0.04 [95% CI: -0.06, -0.039] in a range from 0 to 1) and 12 months (-0.02 [95% CI: -0.04, -0.01]) in the imputation analysis. Complete case analysis showed similar results. The annual disability weight of PE for DALY calculation was conservatively estimated at 0.03 (95% CI: 0.02, 0.04).
Conclusion: PE was independently associated with a moderate decrease in HrQoL, which persisted 12 months after the acute episode despite partial recovery over time. This degree of impairment is comparable to that imposed by several other cardiopulmonary diseases.
Keywords: Aftercare; Clinical Study; Cohort Studies; Cost of Illness; Disability-Adjusted Life Years; Patient Reported Outcome Measures; Pulmonary Embolism; Quality of Life; Quality-Adjusted Life Years; Venous Thromboembolism.
This study explored the difference in the quality of life between survivors of acute pulmonary embolism in the year after the event and individuals from the general population of the same country (Germany), similar in age, sex and general health status. Key findings: Survivors of acute pulmonary embolism reported poorer health-related quality of life regarding self-care, usual activities and anxiety/depression compared to similar individuals from the general population. Pain/discomfort seemed to be of relevance only in the first few months after pulmonary embolism, while mobility was not reduced. The impairment was independent of age, sex, or other coexisting health conditions.The reduction of the patients’ quality of life after pulmonary embolism is moderate but similar to that seen in some chronic diseases of the heart and the lungs, such as heart failure, asthma or chronic obstructive lung disease. Despite showing some improvement over time, the difference is still noticeable after 12 months.
© The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology.