Quality of Life in Cirrhosis

Abstract

Quality of life is a construct that reflects the positive and negative aspects of one's life, and is expanded upon by health-related quality of life (HRQL), which specifically address the impact of health on patients' well-being. Cirrhosis is the culmination of various pathways that leads into development of advanced hepatic fibrosis with its complications. This paper addresses the impact of cirrhosis on individuals HRQL. In addition, we will define what disease specific and general HRQL instruments aim to measure. We discuss the liver disease specific scales [Chronic Liver Disease Questionnaire (CLDQ), Liver Disease Quality of Life 1.0 (LDQOL)] and the most commonly used generic health profile [Short Form 36 Profile (SF-36)]. Furthermore, we examine recent literature which describes how to measure and what is known about quality of life of patients with cirrhosis. This information gives insight to health care providers concerning the impact of disease on patients if treatments are not only to improve health but also function and unexpected treatment outcomes.

Challenges and opportunities in drug and biomarker development for nonalcoholic steatohepatitis: Findings and recommendations from an American Association for the Study of Liver Diseases–U.S. Food and Drug Administration Joint Workshop

“…There is a body of data that supports that the development of histologically identified cirrhosis predicts a significant worsening of health status. Differences in progression to cirrhosis between treatment and control groups were discussed at the workshop as a potential clinically meaningful outcome measure for clinical trials . However, there are known weaknesses that are well documentated and discussed in the literature with using histopathology assessments in clinical trials and limitations to their use in clinical practice.…”

Quality of life in liver transplant recipients and the influence of sociodemographic factors

“…These include muscle cramps, weight loss, hepatic encephalopathy and ascites, and influence the feeling of well-being and satisfaction with life of patients, and negatively affect their quality of life (QOL) (1) . Faced with a degenerative and progressive disease, liver transplantation is recommended as an alternative therapy, allowing for the reversal of the terminal condition and improvement of these patients' quality of life (2) .…”

In patients with liver cirrhosis, proinflammatory interleukins correlate with health-related quality of life irrespective of minimal hepatic encephalopathy

“…A number of studies reported in the last decade have convincingly shown that quality of life is significantly impaired in patients with both compensated and decompensated cirrhosis as compared with the general population [12][13][14][15]. The identified factors relating to an impaired quality of life included nonalcoholic etiology of cirrhosis, higher Child-Pugh score, as an indicator of liver disease severity, but mostly a history of previous or current complications of cirrhosis: ascites, HE, hyponatremia, edema in the legs, or muscle cramps.…”