OC 42.3 - Quantifying anxiety and identifying associated factors in the post-acute phase of venous thromboembolism: Insights from a prospective cohort study

Background: Patients with venous thromboembolism (VTE) are not only at risk for physical consequences, but also psychological sequelae. However, the complex interplay between VTE and mental health remains understudied.

Aims: To investigate anxiety three months after VTE and its association with clinical characteristics.

Methods: We conducted a prospective, observational cohort study, including patients with acute VTE within 21 days of diagnosis. Anxiety was assessed with the PROMIS short form 8a at baseline and at three-month follow-up. Standardized T-scores were calculated with the online scoring tool, with a reference value of 50 (standard deviation (SD), 10) and higher values indicating more anxiety. Associations between clinical characteristics at baseline and T-scores at follow-up were evaluated with a multivariable linear regression model.

Results: We included 258 patients (40.3% women, 46.9% pulmonary embolism, 59.3% unprovoked event, 29.5% VTE history) with a median (interquartile range, IQR) age of 54.6 (43.3-63.5) years and BMI of 27.7 (24.6-31.9) kg/m². Mean (SD) T-scores at baseline and follow-up were 51.0 (9.3) and 46.8 (8.9), respectively. 60 patients (23.3%) reported increase of anxiety at follow-up (Fig. 1). In a multivariable regression model, female sex was associated with increased T-scores at follow-up (3.1, 95% confidence interval (CI), 1.0-5.2), while presence of VTE history was associated with reduced T-scores (-1.8, 95%CI, -3.9-0.3). Presence of PE (-0.6, 95%CI, -2.5-1.3) and unprovoked event (-0.5, 95%CI, -2.5-1.5) were not associated with anxiety. Higher age, higher BMI, and more anxiety at baseline were associated with more anxiety at follow-up, although there was a plateau above the age of 40 years and a drop between 28 and 35 kg/m² BMI in predicted T-scores (Fig. 2).

Conclusion(s): While most patients with VTE reported reduced anxiety over time, some patients experienced worsening during the post-acute phase. Female sex, VTE history, age, BMI, and anxiety at baseline were associated with anxiety three months after VTE.