Highlights
- •One in five patients suffers from depression or anxiety after pulmonary embolism.
- •Association of risk stratification and depression decreases over time.
- •Persistent dyspnoea is associated with emotional harm 2 years after the acute event.
- •Careful monitoring the mental health of patients with pulmonary embolism is needed.
Abstract
Introduction
Pulmonary embolism (PE) is an acute life-threatening event. Besides known physical
long-term consequences such as persistent dyspnoea or reduced physical performance,
less attention is given to the emotional experience.
Methods
We used data from patients with PE of the ‘Lungenembolie Augsburg (LEA)’ cohort study
at University Hospital Augsburg. Baseline characteristics were collected during hospital
stay and participants received postal questionnaires 3, 6, 12, and 24 months after
their PE event. Mental problems were assessed by the Hospital Anxiety and Depression
Scale (HADS). Differences in baseline characteristics in patients with or without
depression or anxiety at 3 months were tested. Linear mixed models were built to explore
long-term effects.
Results
About one-in-five of the 297 patients suffered from depressive or anxiety symptoms
after PE. Patients with depressiveness 3 months after PE were found to be significantly
older, had a higher simplified pulmonary embolism severity index (sPESI), higher education
level, more frequently previous depression, lower oxygen saturation, and a longer
hospital stay. Linear mixed models revealed significant associations of age, history
of depression and sPESI with HADS depression score, and symptoms of dyspnoea with
HADS anxiety score after PE. While the association with sPESI decreased over time,
persistent dyspnoea and limitations in daily life showed constant associations over
the two-year time period for both, depression and anxiety.
Conclusions
The findings highlight depression and anxiety to be common in patients with PE and
reveal possible predictors. Careful monitoring the mental health of patients with
PE is needed for early detection and intervention.
Abbreviations:
BMI (body mass index), CRQ (Chronic Respiratory Disease Questionnaire), HADS (Hospital Anxiety and Depression Scale), IQR (interquartile range), LEA (Lungenembolie Augsburg study), LRT (likelihood ratio test), sPESI (simplified pulmonary embolism severity index), PE (pulmonary embolism), PEmb-QoL (Pulmonary Embolism Quality of Life), VTE (venous thromboembolism)Keywords
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Article info
Publication history
Published online: December 24, 2022
Accepted:
December 19,
2022
Received in revised form:
December 5,
2022
Received:
August 23,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
