Quality of life in patients with chronic liver disease

Dusan Dj Popović; Darija Kisć-Tepavčević; Nada Kovačević; Tamara Alempijević; Miodrag Krstić; Ivan Ranković; Jelena Martinov; Tijana Glišić; Rada Ješić; Tatjana Pekmezović

doi:10.2298/VSP160616339P

Dusan Dj Popović Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
Darija Kisć-Tepavčević Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Institute of Epidemiology, Belgrade, Serbia
Nada Kovačević Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
Tamara Alempijević Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
Miodrag Krstić Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
Ivan Ranković Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
Jelena Martinov Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
Tijana Glišić Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
Rada Ješić Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
Tatjana Pekmezović University of Belgrade, Faculty of Medicine, Institute of Epidemiology, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP160616339P

Keywords: liver diseases;, hepatic insufficiency;, quality of life;, serbia;, sociological factors;, demography;, depression;, surveys and questionnaires.

Abstract

Background/Aim. Quality of life is impaired in patients with the chronic liver disease (CLD). Patients with this disease have numerous disabling problems which lead to a reduced health related quality of life (HRQoL). The aim of our study was to evaluate the predictive value of selected socio-demographic and clinical characteristics on HRQoL in Serbian cohort of patients with the CLD. Methods. Over a period of one year, we performed a study which included patients with the CLD. We used Short Form Health Survay-36 (SF-36) for assessment of HRQoL. The assessment of depression and anxiety was made by using Hamilton scale of depression and anxiety, while the assessment of fatigue was performed by Fatigue severity scale. Results. The study included 103 patients with the CLD. The average values of the overall SF-36 scores were 52.6 ± 20.4, while the mean score of the composite scores were 53.5 ± 19.6 for the Mental component summary and 49.8 ± 21.3 for the Physical component summary. Some domains of HRQoL were significantly affected by following factors: gender, age, employment status, alcohol consumption, depression, anxiety and fatigue. Predictors of physical components of HRQoL were employment, depression and fatigue, and predictors of mental components were depression and fatigue. Conclusion. The tested socio-demographic, clinical and behavioral factors have an impact on the HRQoL in patients with the CLD. The most important predictors of HRQoL are behavioral factors suggesting the need for an adequate therapeutic action in order to improve the HRQoL in these patients.

References

REFERENCE:

Younossi ZM, Kiwi ML, Boparai N, Price LL, Guyatt G. Chole-static liver diseases and health-related quality of life. Am J Ga-stroenterol 2000; 95(2): 497–502.

Younossi ZM, Guyatt G, Kiwi M, Boparai N, King D. Develop-ment of a disease specific questionnaire to measure health re-lated quality of life in patients with chronic liver disease. Gut 1999; 45(2): 295–300.

Glise H, Wilklund I. Health-related quality of life and gastroin-testinal disease. J Gastroenterol Hepatol 2002; 17 Suppl: S72 ̶ 84.

Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30(6): 473–83.

Popović D. Quality of life in patients with liver cirrhosis [disser-tation]. Belgrade: Faculty of Medicine, Univeristy of Belgrade; 2013. (Serbian)

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): 7792–7.

Golabi P, Otgonsuren M, Cable R, Felix S, Koenig A, Sayiner M, et al. Non-alcoholic Fatty Liver Disease (NAFLD) is associated with impairment of Health Related Quality of Life (HRQOL). Health Qual Life Outcomes 2016; 14(1): 18.

Bao Z, Qiu D, Ma X, Fan Z, Zhang G, Huang Y, et al. Assess-ment of health-related quality of life in Chinese patients with minimal hepatic encephalopathy. World J. Gastroenterol. 2007; 13(21): 3003 ̶ 8.

van der Plas SM, Hansen BE, de Boer JB, Stijnen T, Passchier J, de Man RA, et al. Generic and disease-specific health related quality of life in non-cirrhotic, cirrhotic and transplanted liver patients: A cross-sectional study. BMC Gastroenterol 2003; 3: 33.

Cheung AC, Patel H, Meza-Cardona J, Cino M, Sockalingam S, Hirschfield GM. Factors that Influence Health-Related Quality of Life in Patients with Primary Sclerosing Cholangitis. Dig Dis Sci 2016; 61(6): 1692–9.

Björnsson E, Verbaan H, Oksanen A, Frydén A, Johansson J, Friberg S, et al. Health-related quality of life in patients with different stages of liver disease induced by hepatitis C. Scand J Gastroenterol 2009; 44(7): 878–87.

Kallman J, O'Neil MM, Larive B, Boparai N, Calabrese L, Younossi ZM. Fatigue and health-related quality of life (HRQL) in chronic hepatitis C virus infection. Dig Dis Sci 2007; 52(10): 2531–9.

Gutteling JJ, de Man RA, Busschbach JJ, Darlington AS. Overview of research on health-related quality of life in patients with chronic liver disease. Neth J Med 2007; 65(7): 227–34.

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): 2199–205.

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): 170–8.

Kim SH, Oh EG, Lee WH. Symptom experience, psychological distress, and quality of life in Korean patients with liver cirrhosis: a cross-sectional survey. Int J Nurs Stud 2006; 43(8): 1047–56.

Kalaitzakis E, Josefsson A, Björnsson E. Type and etiology of liver cirrhosis are not related to the presence of hepatic encephalopathy or health-related quality of life: A cross-sectional study. BMC Gastroenterol 2008; 8: 46.

Tillmann HL, Wiese M, Braun Y, Wiegand J, Tenckhoff S, Mössner J, et al. Quality of life in patients with various liver diseases: Patients with HCV show greater mental impairment, while pa-tients with PBC have greater physical impairment. J Viral He-pat 2011; 18(4): 252–61.

Kollia Z, Patelarou E, Vivilaki V, Kollia E, Kefou F, Elefsiniotis I, et al. Translation and validation of the Greek chronic liver disease questionnaire. World J Gastroenterol 2010; 16(46): 5838–44.

Afendy A, Kallman JB, Stepanova M, Younoszai Z, Aquino RD, Bi-anchi G, et al. Predictors of health-related quality of life in pa-tients with chronic liver disease. Aliment Pharmacol Ther 2009; 30(5): 469–76.

Häuser W, Holtmann G, Grandt D. Determinants of health-related quality of life in patients with chronic liver diseases. Clin Gastroenterol Hepatol 2004; 2(2): 157–63.

Zuberi BF, Memon AR, Afsar S, Qadeer R, Kumar R. Corre-lation of quality of life in patients of cirrhosis of liver with etiology and disease severity using disease-specific quality of life questionnaire. J Ayub Med Coll Abbottabad 2007; 19(2): 7–11.

Les I, Doval E, Flavià M, Jacas C, Cárdenas G, Esteban R, et al. Quality of life in cirrhosis is related to potentially treatable factors. Eur J Gastroenterol Hepatol 2010; 22(2): 221–7.

Atiq M, Gill ML, Khokhar N. Quality of life assessment in Pa-kistani patients with chronic liver disease. J Pak Med Assoc 2004; 54(3): 113–5.

Sobhonslidsuk A, Silpakit C, Kongsakon R, Satitpornkul P, Sripetch C. Chronic liver disease questionnaire: Translation and valida-tion in Thais. World J Gastroenterol 2004; 10(13): 1954–7.

Gutteling JJ, de Man RA, van der Plas SM, Schalm SW, Busschbach JJ, Darlington AS. Determinants of quality of life in chronic liver patients. Aliment Pharmacol Ther 2006; 23(11): 1629–35.

Teuber G, Schäfer A, Rimpel J, Paul K, Keicher C, Scheurlen M, et al. Deterioration of health-related quality of life and fatigue in patients with chronic hepatitis C: Association with demographic factors, inflammatory activity, and degree of fi-brosis. J Hepatol 2008; 49(6): 923–9.

Benito de Valle M, Rahman M, Lindkvist B, Björnsson E, Chapman R, Kalaitzakis E. Factors that reduce health-related quality of life in patients with primary sclerosing cholangitis. Clin Gastroenterol Hepatol 2012; 10(7): 769–75.e2.

Karaivazoglou K, Iconomou G, Triantos C, Hyphantis T, Thomopoulos K, Lagadinou M, et al. Fatigue and depressive symptoms asso-ciated with chronic viral hepatitis patients. health-related quality of life (HRQOL). Ann Hepatol 2010; 9(4): 419–27.

Popović DD, Ćulafić DM, Tepavčević DB, Kovačević NV, Špuran MM, Djuranović SP, et al. Assessment of depression and anxiety in patients with chronic liver disease. Vojnosanit Pregl 2015; 72(5): 414–20.

Saab S, Bownik H, Ayoub N, Younossi Z, Durazo F, Han S, et al. Differences in health-related quality of life scores after ortho-topic liver transplantation with respect to selected socioeco-nomic factors. Liver Transpl 2011; 17(5): 580–90.

Popovic DD, Kovacevic NV, Kisic-Tepavcevic DB, Trajkovic GZ, Alempijevic TM, Spuran MM, et al. Validation of the chronic liver disease questionnaire in Serbian patients. World J Gastroenterol 2013; 19(30): 4950–7.

Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959; 32(1): 50.

Hamilton M. Developement of a rating scale for primary de-pressive illness. Br J Soc Clin Psychol 1967; 6(4): 278–86.

Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The Fa-tigue Severity Scale. Application to patients with multiple sclerosis and systematic lupus erythematosus. Arch Neurol 1989; 46(10): 1121–3.

Erim Y, Tagay S, Beckmann M, Bein S, Cicinnati V, Beckebaum S, et al. Depression and protective factors of mental health in people with hepatitis C: a questionnaire survey. Int J Nurs Stud 2010; 47(3): 342–9.

Singh N, Gayowski T, Wagener MM, Marino IR. Depression in patients with cirrhosis. Impact on outcome. Dig Dis Sci 1997; 42(7): 1421–7.

Bianchi G, Marchesini G, Nicolino F, Graziani R, Sgarbi D, Loguercio C, et al. Psychological status and depression in pa-tients with liver cirrhosis. Dig Liver Dis 2005; 37(8): 593–600

Swain MG. Fatigue in liver disease: pathophysiology and clini-cal management. Can J Gastroenterol 2006; 20(3): 181–8.

Goldblatt J, Taylor PJ, Lipman T, Prince MI, Baragiotta A, Bassendine MF, et al. The true impact of fatigue in primary bi-liary cirrhosis: A population study. Gastroenterology 2002; 122(5): 1235–41.