The Impact of Permanent Stress Caused by the War in Ukraine on the State of Patients With Portal Hypertension Due to Liver Cirrhosis

Abstract

The aim of the study was to evaluate the impact of permanent stress and features of medical care in martial law on the indicators of liver function and quality of life of patients with portal hypertension due to liver cirrhosis.
 Materials and methods. The study included 37 patients with a confirmed diagnosis of liver cirrhosis complicated by portal hypertension and esophageal variceal bleeding. According to performed interventions all patients were divided into 3 groups: Group 1 – endoscopic band ligation and partial splenic artery embolization; Group 2 – endoscopic band ligation; Group 3 – endoscopic band ligation. The difference between Group 2 and Group 3 patients was that Group 2 patients were in a state of permanent stress due to the war. There were 4 visits with an interval of 1 month. At each time point, the levels of laboratory parameters of functional state of the liver and quality of life using RAND SF-36 questionnaire were evaluated.
 Results. Patients in all three groups during the first month showed an improvement in both laboratory indicators of liver function and integrated quality of life. In patients of Group 1 there was a progressive improvement in both the functional status of the liver and quality of life. In Group 2 the lack of any manipulations and maintenance therapy led to a lack of positive dynamics in patients. Staying in a state of permanent stress led to a progressive deterioration in the condition of patients in Group 3 starting from the second visit. Initially, the deterioration affected only the quality of life, but later it also manifested itself as a violation of the indicators of the functional state of the liver.
 Conclusions. The cumulative effect of permanent stress in patients with liver cirrhosis complicated by portal hypertension is manifested by an early deterioration in the quality of life with later violations of liver function.