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Reduction in physical function in women after venous thromboembolism
Author(s): ,
K. A. Hagan
Affiliations:
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
Correspondence: Kaitlin A Hagan, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA|Tel.: +1 617 525 2096|E‐mail: nhkah@channing.harvard.edu
,
L. B. Harrington
Affiliations:
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
,
J. Kim
Affiliations:
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
,
O. Zeleznik
Affiliations:
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
,
E. B. Rimm
Affiliations:
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
,
F. Grodstein
Affiliations:
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
C. Kabrhel
Affiliations:
Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, USA
ISTH Academy. A Hagan K. Aug 2, 2018; 227439
Kaitlin A Hagan
Kaitlin  A Hagan

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Background
Physical function is integral to healthy aging; however, limited research has examined the association of venous thromboembolism(VTE) with subsequent physical function.
Objectives
To prospectively evaluate the relationship between VTE and decline in physical function among 80 836 women from the Nurses’ Health Study(NHS), ages 46–72 in 1992, and 84 304 women from the Nurses’ Health Study II(NHS II), ages 29–48 in 1993.
Methods
Physical function was measured by the Medical Outcomes Short Form‐36 physical function scale, administered every 4 years. We compared change in physical function for women with vs. without an incident VTE in each 4‐year follow‐up period using multivariable linear regression.
Results
We observed a decline in physical function over 4 years when comparing women with vs. those without incident VTE in both older (NHS) and younger (NHS II) women (multivariable‐adjusted mean difference NHS, −6.5 points [95% CI −7.4, −5.6] per 4 years; NHS II, −3.8 [95% CI −5.6, −2.0]). This difference appeared greater among women specifically reporting a pulmonary embolism (NHS, −7.4 [95% CI −8.7, −6.1]; NHS II, −4.8 [95% CI −6.8, −2.8]), and was equivalent to 6.2 years of aging. Whereas longer‐term slopes of physical function decline following a VTE were not different from the slopes of decline in women without a VTE, the absolute level of physical function of women with VTE was worse at the end of follow‐up compared to women without VTE.
Conclusions
In this prospective cohort, incident VTE was strongly associated with an acute decline in physical function. These results suggest it may be clinically important to consider approaches to ameliorating functional deficits shortly after VTE diagnosis.
Keyword(s)
cohort studies, epidemiology, physical and rehabilitation medicine, pulmonary embolism, venous thromboembolism
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