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Quality of life in cirrhosis is related to potentially treatable factors

Les, Iñigoa d f; Doval, Eduardoe; Flavià, Montserrata f; Jacas, Carlosb d f; Cárdenas, Guillermoc f; Esteban, Rafaela d f; Guardia, Jaimea d f; Córdoba, Juana d f

European Journal of Gastroenterology & Hepatology: February 2010 - Volume 22 - Issue 2 - pp 221-227
doi: 10.1097/MEG.0b013e3283319975
Original Articles: Decompensated Liver Disease

Objective: Improvement of prognosis and availability of diverse therapeutic options for complications of advanced liver disease highlight the importance of health-related quality of life (HRQOL) in cirrhosis. The aim of this study was to identify factors that influence HRQOL and may be potentially treatable in patients with cirrhosis.

Methods: HRQOL was measured in 212 outpatients with cirrhosis using a generic questionnaire (Medical Outcomes Study Form, SF-36) and a liver-specific questionnaire (Chronic Liver Disease Questionnaire, CLDQ). All patients underwent a systematic clinical and neuropsychological assessment. Independent factors associated with poor HRQOL were identified by multiple linear regression.

Results: HRQOL scores exhibited by patients were: global CLDQ: 4.8±1.2; Physical Component Score of SF-36: 38.5±10.7; Mental Component Score of SF-36: 45.3±14.3. The independent variables for global CLDQ were female sex, nonalcoholic etiology, current ascites, and a decrease in albumin (R2 = 0.22). For Physical Component Score of SF-36, the independent variables were prior hepatic encephalopathy, current ascites, and a decrease in hemoglobin (R2 = 0.22). For Mental Component Score of SF-36, the independent variables were nonalcoholic etiology, the Grooved Pegboard test, and a decrease in hemoglobin (R2 = 0.14).

Conclusion: 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.

aServei de Medicina Interna-Hepatologia

bUnitat de Neuropsicologia Clínica

cUnitat de Suport Nutricional, Hospital Vall d'Hebron

dDepartament de Medicina

eDepartament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona

fCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain

Correspondence to Dr Juan Córdoba, MD, Servei de Medicina Interna-Hepatologia, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119, Barcelona 08035, Spain Tel: +34 93 2746140; fax: +34 93 2746068; e-mail:

Received 20 May 2009 Accepted 6 August 2009

© 2010 Lippincott Williams & Wilkins, Inc.