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

BMC Research Notes

Wasim Jafri³  Iqbal Azam²  Fatima Jafri¹  Romaina Iqbal²  Om Parkash³ 

[1] Medical College, Aga Khan University, Karachi, Pakistan;Community Health Sciences, Aga Khan University Karachi, Karachi, Pakistan;Department of Medicine, Aga Khan University Karachi, Karachi, Pakistan

关键词: Hepatitis C and Hepatitis B;    Health related Quality of life;    Cirrhosis;    Upper GI bleed;    Quality of life;    Ascites;    Hepatic encephalopathy;    Chronic liver disease;    Hepatitis;   

Others  :  1165922
DOI  :  10.1186/1756-0500-5-446

 received in 2012-03-03, accepted in 2012-08-10,  发布年份 2012

【 摘 要 】

Background

Cirrhosis 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.

Findings

This 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.

Conclusion

Frequency 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.

【 授权许可】

   
2012 Parkash et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Hauser W, Zimmer C, Schiedermaier P, Grandt D: Biopsychosocial predictors of health-related quality of life in patients with chronic hepatitis C. Psychosom Med 2004, 66(6):954-958.
• [2]Norman K, Kirchner H, Lochs H, Pirlich M: Malnutrition affects quality of life in gastroenterology patients. World J Gastroenterol 2006, 12(21):3380-3385.
• [3]Sumskiene J, Sumskas L, Petrauskas D, Kupcinskas L: Disease-specific health-related quality of life and its determinants in liver cirrhosis patients in Lithuania. World J Gastroenterol 2006, 12(48):7792-7797.
• [4][cited]Available from: http://www.who.int/about/definition/en/print.html/ webcite
• [5]Younossi ZM, Boparai N, Price LL, Kiwi ML, McCormick M, Guyatt G: Health-related quality of life in chronic liver disease: the impact of type and severity of disease. Am J Gastroenterol 2001, 96(7):2199-2205.
• [6]Addington-Hall J, Kalra L: Who should measure quality of life? BMJ 2001, 322(7299):1417-1420.
• [7]Younossi ZM, Guyatt G, Kiwi M, Boparai N, King D: Development of a disease specific questionnaire to measure health related quality of life in patients with chronic liver disease. Gut 1999, 45(2):295-300.
• [8]Martin LM, Dan AA, Younossi ZM: Measurement of health-related quality of life in patients with chronic liver disease. Liver Transpl 2006, 12(1):22-23.
• [9]Zandi M, Adib-Hajbagheri M, Memarian R, Nejhad AK, Alavian SM: Effects of a self-care program on quality of life of cirrhotic patients referring to Tehran Hepatitis Center. Health Qual Life Outcomes 2005, 3:35. BioMed Central Full Text
• [10]Jafar TH, Hatcher J, Poulter N, Islam M, Hashmi S, Qadri Z, et al.: Community-based interventions to promote blood pressure control in a developing country: a cluster randomized trial. Ann Intern Med 2009, 151(9):593-601.
• [11]Khan P, Ahmad A, Muhammad N, Khan TM, Ahmad B: Screening of 110 cirrhotic patients for hepatitis B and C at Saidu Teaching Hospital Saidu Sharif Swat. J Ayub Med Coll Abbottabad 2009, 21(1):119-121.
• [12]Bukhtiari N, Hussain T, Iqbal M, Malik AM, Qureshi AH, Hussain A: Hepatitis B and C single and co-infection in chronic liver disease and their effect on the disease pattern. J Pak Med Assoc 2003, 53(4):136-140.
• [13]Kamani L, Mumtaz K, Ahmed US, Ali AW, Jafri W: Outcomes in culture positive and culture negative ascitic fluid infection in patients with viral cirrhosis: cohort study. BMC Gastroenterol 2008, 8:59. BioMed Central Full Text
• [14]Bondini S, Kallman J, Dan A, Younoszai Z, Ramsey L, Nader F, et al.: Health-related quality of life in patients with chronic hepatitis B. Liver Int 2007, 27(8):1119-1125.
• [15]Marchesini G, Bianchi G, Amodio P, Salerno F, Merli M, Panella C, et al.: Factors associated with poor health-related quality of life of patients with cirrhosis. Gastroenterology 2001, 120(1):170-178.
• [16]Foster GR, Goldin RD, Thomas HC: Chronic hepatitis C virus infection causes a significant reduction in quality of life in the absence of cirrhosis. Hepatology 1998, 27(1):209-212.
• [17]Saab S, Ibrahim AB, Shpaner A, Younossi ZM, Lee C, Durazo F, et al.: MELD fails to measure quality of life in liver transplant candidates. Liver Transpl 2005, 11(2):218-223.
• [18]Sobhonslidsuk A, Silpakit C, Kongsakon R, Satitpornkul P, Sripetch C: Chronic liver disease questionnaire: translation and validation in Thais. World J Gastroenterol 2004, 10(13):1954-1957.
• [19]Les I, Doval E, Flavia M, Jacas C, Cardenas G, Esteban R, et al.: Quality of life in cirrhosis is related to potentially treatable factors. Eur J Gastroenterol Hepatol 2010, 22(2):221-227.
• [20]Silverberg DS, Wexler D, Blum M, Tchebiner JZ, Sheps D, Keren G, et al.: The effect of correction of anaemia in diabetics and non-diabetics with severe resistant congestive heart failure and chronic renal failure by subcutaneous erythropoietin and intravenous iron. Nephrol Dial Transplant 2003, 18(1):141-146.
• [21]Drueke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D, et al.: Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med 2006, 355(20):2071-2084.
• [22]Silverberg DS, Wexler D, Blum M, Schwartz D, Keren G, Sheps D, et al.: Effect of correction of anemia with erythropoietin and intravenous iron in resistant heart failure in octogenarians. Isr Med Assoc J 2003, 5(5):337-339.
• [23]D'Amico G, Morabito A, Pagliaro L, Marubini E: Survival and prognostic indicators in compensated and decompensated cirrhosis. Dig Dis Sci 1986, 31(5):468-475.
• [24]Henriksen JH, Fuglsang S, Bendtsen F, Christensen E, Moller S: Arterial compliance in patients with cirrhosis: stroke volume-pulse pressure ratio as simplified index. Am J Physiol Gastrointest Liver Physiol 2001, 280(4):G584-G594.
• [25]Henriksen JH, Moller S, Schifter S, Bendtsen F: Increased arterial compliance in decompensated cirrhosis. J Hepatol 1999, 31(4):712-718.
• [26]Moller S, Wiinberg N, Hernriksen JH: Noninvasive 24-hour ambulatory arterial blood pressure monitoring in cirrhosis. Hepatology 1995, 22(1):88-95.