Quality of life in cirrhosis is related to potentially treatable factors

Les, Íñigo; Diéguez, Eduardo Doval; Flavià, Montserrat; Jacas, Carlos; Cárdenas, Guillermo; Esteban, Rafael; Guàrdia, J; Córdoba, Juan

doi:10.1097/meg.0b013e3283319975

Cited by 130 publications

(118 citation statements)

References 32 publications

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“…The overall CLDQ score as well as the domain sub scores showed an inverse relationship with the disease severity. Similar pattern of association between Child Pugh Score and CLDQ has been demonstrated by other studies also 3,11,16,[23][24][25] . The post-hoc analysis revealed that the average and the sub scores of patients with Child C were significantly low than patients with both Child A and B, however most of the studies using CLDQ have not been able to differentiate between Child C and B 3,6,26 .…”

supporting

confidence: 66%

Translation and validation of the Hindi version of chronic liver disease questionnaire (CLDQ) for the assessment of health related quality of life in patient with chronic liver disease in India

Benjamin¹,

Mani²,

Saraya³

et al. 2016

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Background: Chronic liver disease questionnaire (CLDQ) is an established disease specific tool to assess the health related quality of life (HRQOL) in patients with CLD irrespective of the etiology and severity. The objective of the study was to develop the Hindi language version of CLDQ and to assess the validity of the Hindi CLDQ. Methods: CLDQ was adapted into Hindi language by following a standard method of forward and back-translation by two bilingual translators, revision by expert panel and formulation of a consensual version followed by pilot testing and appropriate modifications before final administration. Hindi CLDQ along with short form 36 (SF-36) were administered in 494 patients with chronic liver disease (CLD) and 103 healthy controls (HC). To assess reproducibility, Hindi CLDQ was re-administered in a subsample of 20 patients. Internal consistency was assessed by Cronbach's alpha coefficient. Structural validity was assessed by exploratory factor analysis and construct validity was assessed with help of correlation of SF-36 scores and CLDQ pattern across disease severity groups. Results: The Cronbach's alpha coefficient was 0.93 and intra class coefficient correlation was 0.88 for the average CLDQ score, suggestive of good reliability. An inverse relationship of the average CLDQ score with the disease severity (CLDQ score of Child A vs. B vs. C = 5.2±1.10 vs. 4.73±1.24 vs. 4.15±1.19 respectively; p<0.001) and good correlation with SF-36 scores (average CLDQ score with PCS & MCS; r=0.63 & 0.55; p<0.001) was suggestive of good validity of Hindi CLDQ. The factor analysis identified 6 domains accounting for 62% of variability. The derived cut-off of 6 for the average CLDQ had the AUC of 0.826 with a sensitivity of 82.6 and a specificity of 76.7. Conclusion: Hindi version of CLDQ is found to be a reliable and a valid tool comparable to the original English version. The HRQOL of patients with CLD is lower than healthy controls and HRQOL decreases with increase in disease severity.

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supporting

confidence: 66%

Translation and validation of the Hindi version of chronic liver disease questionnaire (CLDQ) for the assessment of health related quality of life in patient with chronic liver disease in India

Benjamin¹,

Mani²,

Saraya³

et al. 2016

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“…Les et al 14 defendem que fatores potencialmente tratáveis contribuem de forma independente para a alteração da percepção da QV. Eles concluíram que determinados fatores psicológicos modificáveis estavam associados à pior percepção da QV, principalmente em pacientes com dependência alcoólica.…”

Section: Discussionunclassified

Qualidade de vida de candidata ao transplante de fígado após intervenção fisioterapêutica: relato de caso

Filho

Nascimento

Reche

et al. 2017

Rev. Fac. Ciênc. Méd. Sorocaba

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RESUMOO objetivo do presente estudo foi avaliar o impacto de um programa de reabilitação física sobre a qualidade de vida de uma paciente candidata ao transplante de fígado. Trata-se de uma paciente do sexo feminino, 43 anos, diagnóstico médico de cirrose biliar primária, fibrose porta-porta, há seis anos, Child B e MELD 17, antecedente de hipertensão arterial sistólica, diabetes mellitus e dislipidemia. Foi avaliada antes e após aplicação do protocolo de reabilitação em cinco sessões consecutivas, por meio do questionário Chronic Liver Disease Questionnaire (CLDQ). Observou-se uma resposta positiva na melhoria da qualidade de vida da paciente quando submetida ao programa de reabilitação física, porém, de forma discreta, devido à percepção de limitações funcionais pertinentes à doença, demonstrando alteração emocional. Este estudo permitiu uma abordagem criteriosa da candidata quanto às suas limitações pessoais e características da doença para servirem como parâmetro a um programa de tratamento fisioterapêutico, baseado na reabilitação e melhora da qualidade de vida. Novos estudos poderão ser desenvolvidos sobre o tema abordado, o que contribuirá de forma direta na ampliação do conhecimento, enriquecimento e atualização da literatura científica. Palavras-chave: qualidade de vida; transplante de fígado; fisioterapia; cirrose hepática; cuidados pré-operatórios. ABSTRACTThe objective of the present study was to evaluate the impact of a physical rehabilitation program on the quality of life of a patient who is candidate for liver transplantation. This is a female patient, 43 years old, diagnosed with primary biliary cirrhosis, portal fibrosis six years ago, Child B and MELD 17, previous systolic hypertension, diabetes mellitus and dyslipidemia. It was evaluated before and after the application of the rehabilitation protocol in five consecutive sessions, using the Chronic Liver Disease Questionnaire (CLDQ). A positive response was observed in the improvement of the patient's quality of life when submitted to the physical rehabilitation program, but in a discrete way, due to the perception of relevant functional limitations of the disease, demonstrating emotional alteration. This study allowed a careful approach of the candidate regarding their personal limitations and characteristics of the disease to serve as a parameter for a program of physiotherapeutic treatment, based on rehabilitation and improvement of the quality of life. New studies may be developed on the topic addressed, which will directly contribute to the expansion of knowledge, enrichment and updating of the scientific literature. Keywords: quality of life; liver transplantation; physical therapy specialty; liver cirrhosis; preoperative care. INTRODUÇÃOO transplante de fígado (TxF) é um procedimento cirúrgi-co adotado em pacientes portadores de doença hepática crônica (DHC) ou aguda nos quais os tratamentos conservadores não se mostram eficazes.1 O TxF oferece aos pacientes a oportunidade para melhor sobrevivência e melhoria da qualidade de vida (QV). ...

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“…32 Tacke et al 33 reported on Epo upregulation in patients with chronic liver diseases. Thus, the exogenous application with respect to endogenously increased Epo levels may appear as a discrepancy.…”

Section: Discussionmentioning

confidence: 99%

Darbepoetin-α inhibits the perpetuation of necro-inflammation and delays the progression of cholestatic fibrosis in mice

Sigal

Siebert

Zechner

et al. 2010

Laboratory Investigation

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Biliary obstruction and cholestasis result in hepatocellular necro-inflammation and lead to the development of liver fibrosis. The objective of this study was to analyze whether the multiple tissue-protective properties of erythropoietin are salutary in an experimental model of liver fibrosis. For this purpose, C57BL/6J mice underwent common bile duct ligation (BDL) and were treated with either darbepoetin-a (10 mg/kg i.p.) or physiological saline every third day, beginning 24 h after BDL. Mice were killed at 2, 5, 14, and 28 days after BDL. Beside hematological parameters, markers of inflammation and fibrosis were assessed histomorphometrically and immunohistochemically as well as by quantitative real-time PCR. In addition, a 7-week survival study was performed. BDL provoked cholestatic hepatitis characterized by biliary infarcts with accumulation of macrophages followed by marked collagen deposition and increased expression of profibrotic gene transcripts. Darbepoetin-a treatment significantly diminished the area of focal necrosis, reduced the infiltration of macrophages, decreased levels of profibrotic genes, and lowered collagen deposition. Moreover, darbepoetin-a significantly reduced systemic anemia caused by BDL. Finally, darbepoetin-a treatment significantly prolonged the survival time after BDL. This study suggests that darbepoetin-a, which is a clinically well-established substance, might be used as an efficient therapeutic option for patients with chronic cholestatic liver disease.

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Quality of life in cirrhosis is related to potentially treatable factors

Abstract: Several clinical variables, potentially treatable, may alter particular aspects of HRQOL. Correction of ascites, hypoalbuminemia, minimal hepatic encephalopathy, and anemia may cause a positive impact on HRQOL of patients with cirrhosis.

Cited by 130 publications

References 32 publications

Translation and validation of the Hindi version of chronic liver disease questionnaire (CLDQ) for the assessment of health related quality of life in patient with chronic liver disease in India

Translation and validation of the Hindi version of chronic liver disease questionnaire (CLDQ) for the assessment of health related quality of life in patient with chronic liver disease in India

Qualidade de vida de candidata ao transplante de fígado após intervenção fisioterapêutica: relato de caso

Darbepoetin-α inhibits the perpetuation of necro-inflammation and delays the progression of cholestatic fibrosis in mice

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