Determinants of quality of life in chronic liver patients.
OBJECTIVE
Health-related quality of life of patients with chronic liver disease has been shown to be impaired in numerous studies. However, the factors which influence health-related quality of life in treated chronic liver patients are not quite known. This is the first study to assess the impact of physical and psychosocial determinants on a weighted score of health-related quality of life in patients with chronic liver disease.


METHODS
The data of 1175 chronic liver patients were used to assess the relationship between items of the disease-specific Liver Disease Symptom Index 2.0 and the Short Form (SF)-6D weighted utility score by means of linear regression analyses.


RESULTS
Health-related quality of life was most strongly related to disease severity (B = -0.029) and joint pain (B = -0.023). Depression (B = -0.014), pain in the right upper abdomen (B = -0.014), decreased appetite (B = 0.014) and fatigue (B = -0.013) were also strongly related to health-related quality of life. In hepatitis C virus patients, disease severity (B = -0.037) and depression (B = -0.030) were strong determinants of health-related quality of life.


CONCLUSIONS
This study shows that health-related quality of life in chronic liver patients is clearly determined by disease severity, joint pain, depression, decreased appetite and fatigue. These patients may benefit most from interventions aimed at improving adaptation to the symptoms described.
Gutteling
J J
JJ
Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands. j.gutteling@erasmusmc.nl
de Man
R A
RA
van der Plas
S M
SM
Schalm
S W
SW
Busschbach
J J V
JJ
Darlington
A-S E
AS
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D001066:Appetite / Q000502:physiology; D018771:Arthralgia / Q000209:etiology; D002908:Chronic Disease; D003866:Depressive Disorder / Q000209:etiology; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index