Frequency of poor quality of life and predictors of health related quality of life in cirrhosis at a tertiary care hospital Pakistan

Abstract

BackgroundCirrhosis produces variety of symptoms which eventually lead to a negative impact on Health Related Quality of Life (HRQOL). The general aim of this study was to evaluate the magnitude of poor HRQOL and to assess factors related with HRQOL in patients with CLD in Pakistan.FindingsThis was a cross sectional study conducted in gastroenterology outpatient clinics of Aga Khan University Hospital, Karachi on adult patients with cirrhosis. In this study chronic liver disease questionnaire (CLDQ) was used to assess HRQOL of these patients and CLDQ score was used as an outcome measure to determine factors related with HRQOL.273 participants were recruited in the study; 155 (57%) were males. Mean age of participants was 49 ± 11 years. The most common cause for cirrhosis was viral infection 247(91.5%). Mean Model for End Stage Liver Disease (MELD) score was 12.6 ± 6.8 and 2/3 of patients 209 (76.6%) had advanced cirrhosis in Child Turcot Pugh (CTP) B or C stage. Poor HRQOL was seen in 187(69%; 95% C.I.: 63%, 74%) of the participants. Mean CLDQ score was 4.36 ±1.1. Amongst all of the domains, fatigue domain had lower CLDQ score. Hemoglobin (β = 0.09 [SE = 0.04]), Albumin (β = 0.32[SE = 0.09]), Diastolic Blood Pressure (DBP) (β = 0.01[0.005) prior history of decompensation (β = 0.98[SE = 0.39] were significant factors associated with HRQOL in patients with liver cirrhosis.ConclusionFrequency of poor health related quality of life determined by CLDQ score is high in patients with liver cirrhosis. Hemoglobin, serum albumen, prior history of decompensation (like encephalopathy and upper gastro intestinal bleed), are associated with health related quality of life.

Health-related quality of life on the clinical course of patients with chronic hepatitis C receiving daclatasvir/asunaprevir therapy: A prospective observational study comparing younger (<70) and elderly (≥70) patients

“…This may have led to the amelioration of HRQOL and ALB through improved liver function. Previous studies have also reported an association between ALB and HRQOL in patients with hemodialysis patients or liver cirrhosis (25,26). Similar results were shown in this study.…”

A quality of life assessment and the correlation between generic and disease-specific questionnaires scores in outpatients with chronic liver disease-pilot study

“…There are concordant results in other similar studies regarding the average age of participants, gender, marital status, and educational status [8,[15][16][17]. Significant predominance of males in different etiologic groups is consistent with the data from literature.…”

“…Also, our results are in orchestra with literature data, and indicate higher frequency of males within the group of alcoholic liver disease patients. This was not the case with the CLD of other etiology, where the distribution by gender was significantly more uniform compared to the previous studies [16][17][18].…”

“…In contrast to this, the results of the study Dan et al [23] show the existence of significantly lower CLDQ scores in all domains except for the "worry" domain in patients with NASH compared with those suffering from viral hepatitis. Study of Parkash et al [16] has found a significantly lower CLDQ score within the group of patients with cirrhosis compared with those without cirrhosis. Similar results were presented by the Younossi et al [21] and Che et al [17], similarly to the severity of CLD with the MELD score from our present study.…”

“…Ranking within groups is presented in Table 1. 3,6,21,23,27), the activity (3 questions; the order of 7, 9, 14), emotional functioning (8 questions; the order of 10,12,15,16,19,20,24,26), as well as concerns (5 questions; the order of 18,22,25,28,29). The average score for each domain is equal to the sum of ranks for all issues related to this area, divided by the number of questions.…”