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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 - p 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 (R 2 = 0.22). For Physical Component Score of SF-36, the independent variables were prior hepatic encephalopathy, current ascites, and a decrease in hemoglobin (R 2 = 0.22). For Mental Component Score of SF-36, the independent variables were nonalcoholic etiology, the Grooved Pegboard test, and a decrease in hemoglobin (R 2 = 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.