Generic and disease-specific health related quality of life in non-cirrhotic, cirrhotic and transplanted liver patients: a cross-sectional study.
BACKGROUND
Studies on Health Related Quality of Life (HRQoL) of chronic liver patients were performed in clinical populations. These studies included various disease stages but small variations in aetiology and no transplanted patients. We performed a large HRQoL study in non-cirrhotic, cirrhotic and transplanted liver patients with sufficient variety in aetiology. We compared the generic HRQoL and fatigue between liver patients and healthy controls and compared the disease-specific and generic HRQoL and fatigue between non-cirrhotic, cirrhotic and transplanted liver patients, corrected for aetiology.


METHODS
Members of the Dutch liver patient association received the Short Form-36, the Liver Disease Symptom Index and the Multidimensional Fatigue Index-20. Based on reported clinical characteristics we classified respondents (n = 1175) as non-cirrhotic, compensated cirrhotic, decompensated cirrhotic or transplants. We used linear, ordinal and logistic regression to compare the HRQoL between groups.


RESULTS
All liver patients showed a significantly worse generic HRQoL and fatigue than healthy controls. Decompensated cirrhotic patients showed a significantly worse disease-specific and generic HRQoL and fatigue than non-cirrhotic patients, while HRQoL differences between non-cirrhotic and compensated cirrhotic patients were predominantly insignificant. Transplanted patients showed a better generic HRQoL, less fatigue and lower probabilities of severe symptoms than non-cirrhotic patients, but almost equal probabilities of symptom hindrance.


CONCLUSIONS
HRQoL in chronic liver patients depends on disease stage and transplant history. Non-cirrhotic and compensated cirrhotic patients have a similar HRQoL. Decompensated patients show the worst HRQoL, while transplanted patients show a significantly better HRQoL than cirrhotic and non-cirrhotic patients.
van der Plas
Simone M
SM
Department of Epidemiology and Biostatistics, Erasmus Medical Centre Rotterdam, P,O, box 1738, 3000 DR Rotterdam, The Netherlands. s.vanderplas@erasmusmc.nl
Hansen
Bettina E
BE
de Boer
Josien B
JB
Stijnen
Theo
T
Passchier
Jan
J
de Man
Robert A
RA
Schalm
Solko W
SW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000523:psychology; D008107:Liver Diseases / Q000145:classification / Q000150:complications / Q000523:psychology; D016031:Liver Transplantation / Q000009:adverse effects / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis