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Teshome E, Hailu W, Adane A, Belayneh Melese E, Abebaw Angaw D, Tarekegn GE. Clinical and individual factors of quality of life of chronic liver disease patients at University of Gondar comprehensive specialized hospital, Northwest Ethiopia 2022. Medicine (Baltimore) 2023; 102:e35425. [PMID: 37960830 PMCID: PMC10637558 DOI: 10.1097/md.0000000000035425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/05/2023] [Indexed: 11/15/2023] Open
Abstract
Chronic liver disease (CLD) may be a major cause of morbidity and mortality worldwide, as well as a reduction in health-related quality of life. In Ethiopia, however, little is known about the effect of CLD on quality of life. The purpose of this study was to evaluate CLD patients' health-related quality of life and associated factors. A cross-sectional study was carried out on 227 CLD patients who were being followed up on at the University of Gondar specialized hospital between January 2022 and February 2022. To assess health-related quality of life, the chronic disease Questionnaire was used. Epi-Data version 4.6 was used to enter data, and SPSS version 25 was used for all statistical analysis. To identify factors associated with the outcome variable, a linear regression model was used. Patients with CLD had significantly lower mean scores in all domains of health-related quality of life. Hepatitis B virus treatments and a college education or higher have a positive effect on all domains of health-related quality of life. Upper gastrointestinal bleeding, spontaneous bacterial peritonitis (SBP), hepatic encephalopathy (HE), and ascites were a clinical related factors significantly associated with poor health-related quality of life in simple linear regression. In this study setting, all dimensions of health-related quality of life of patients with CLD were compromised. Antiviral treatment for HBV infection, beta-blocker treatment, and the presence of complications such as ascites were all found to be significantly related to health-related quality of life. This necessitates going above and beyond standard treatments to improve patients' quality of life with CLD.
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Affiliation(s)
- Eliud Teshome
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Workagegnehu Hailu
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aynishet Adane
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Endalkachew Belayneh Melese
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gebrekidan Ewnetu Tarekegn
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tesfaye BT, Feyissa TM, Workneh AB, Gudina EK, Yizengaw MA. Chronic Liver Disease in Ethiopia with a Particular Focus on the Etiological Spectrums: A Systematic Review and Meta-Analysis of Observational Studies. Can J Gastroenterol Hepatol 2021; 2021:8740157. [PMID: 34858892 PMCID: PMC8632430 DOI: 10.1155/2021/8740157] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 02/08/2023] Open
Abstract
Background In Ethiopia, chronic liver disease (CLD) is the 7th leading cause of death, accounting for about 24 deaths per 100000 populations in 2019. Despite its burden, there is a lack of compiled pieces of evidence on CLD in the country. Thus, this systematic review and meta-analysis is intended to provide the pooled estimates of CLD etiologies and mortality rate in CLD patients in Ethiopia. Method PubMed, Google Scholar, ScienceDirect, institutional repositories, national digital library, and the bibliography of the eligible articles information were the source of data for the present review. The keywords "hepatitis, chronic" [Mesh], "end-Stage Liver Disease" [Mesh], "chronic liver disease", "liver cirrhosis" [Mesh], and "Ethiopia" were used for the searches. Overall, we retrieved 199 records and 12 were included in this review. We used the DerSimonian-Laird random-effects models to perform the meta-analysis. We conducted subgroup and meta-regression analyses to account for the heterogeneity of the estimates. Result Hepatitis B virus, alcohol, and hepatitis C virus are the three most common etiologies of CLD in Ethiopia accounting for a pooled estimate of 40.0% [95% CI: 29.0, 51.0, I 2 = 96.3, p < 0.001], 17.0% [95% CI: 9.0, 25.0, I 2 = 96.7, p < 0.001], and 15.0% [95% CI: 9.0, 21.0, I 2 = 95.8, p < 0.001], respectively. Unidentified etiology report has a substantial contribution accounting for an estimated pooled proportion of 45% [95% CI: 34.0, 56.0%, Q = 32.08, p < 0.001, I 2 = 87.53] of the CLD cases in the country. On the other hand, the overall hospital mortality rate in CLD patients is 25.0% [95% CI: 2.0, 47.0, I2 = 94.6, p < 0.001] in Ethiopia. Conclusion Hepatitis B virus, hepatitis C virus, and alcohol are the three most common contributors to CLD cases in Ethiopia. The authors warrant routine screening and strengthening of preventive and treatment programs for viral hepatitis B and C, further enhancing the alcohol policy of the country.
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Affiliation(s)
- Behailu Terefe Tesfaye
- Jimma University, Institute of Health, School of Pharmacy, Clinical Pharmacy Unit, Jimma, Ethiopia
- Jimma University Medical Center, Institute of Health, Jimma, Ethiopia
| | - Temesgen Mulugeta Feyissa
- Jimma University, Institute of Health, School of Pharmacy, Clinical Pharmacy Unit, Jimma, Ethiopia
- Jimma University Medical Center, Institute of Health, Jimma, Ethiopia
| | - Azmeraw Bekele Workneh
- Jimma University Medical Center, Institute of Health, Jimma, Ethiopia
- Jimma University, Institute of Health, School of Pharmacy, Social Pharmacy Unit, Jimma, Ethiopia
| | - Esayas Kebede Gudina
- Jimma University Medical Center, Institute of Health, Jimma, Ethiopia
- Jimma University, Institute of Health, Department of Internal Medicine, Jimma, Ethiopia
| | - Mengist Awoke Yizengaw
- Jimma University, Institute of Health, School of Pharmacy, Clinical Pharmacy Unit, Jimma, Ethiopia
- Jimma University Medical Center, Institute of Health, Jimma, Ethiopia
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Zhang M, Li Y, Fan Z, Shen D, Huang X, Yu Q, Liu M, Ren F, Wang X, Dai L, Wang P, Ye H, Shi J, Yang X, Zhang S, Zhang J. Assessing health-related quality of life and health utilities in patients with chronic hepatitis B-related diseases in China: a cross-sectional study. BMJ Open 2021; 11:e047475. [PMID: 34526336 PMCID: PMC8444251 DOI: 10.1136/bmjopen-2020-047475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES The health-related quality of life (HRQoL) and utilities of patients with chronic hepatitis B (CHB) virus infection, including compensated cirrhosis (CC), decompensated cirrhosis (DC) and different stages of hepatocellular carcinoma (HCC), have not been well described in China. This study aimed to evaluate HRQoL and utilities and provide parameters for the economic evaluation of CHB-related diseases. METHODS We conducted a multicentre cross-sectional and study to measure the HRQoL of patients with CHB, CC, DC and HCC using the Chinese short form (SF) 36 health survey V.2. The utilities were extracted based on the SF-six dimension scoring model. Multivariable regression analyses identified the effects on HRQoL. RESULTS A total of 1071 patients (639 with CHB, 125 with CC, 85 with DC and 222 with HCC) were invited to complete the questionnaire. Physical HRQoL was not impaired in the CHB stage, while mental HRQoL was significantly impaired. Physical composite summary scores have a more significant decrease than mental composite summary scores at the advanced stages (CC, DC and HCC). The utility scores of CHB only, CC, DC and HCC were 0.773, 0.750, 0.683 and 0.640, respectively. The utility scores in the early, middle and terminal stages of HCC were 0.656, 0.635 and 0.615, respectively. CONCLUSION Slowing the progress of CHB-related diseases and providing psychological support early are the key points to improving the quality of life with the diseases. The utility values estimated in this study can provide a vital instrument for cost-effectiveness studies on CHB-related diseases.
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Affiliation(s)
- Meng Zhang
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yaoguang Li
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Zihao Fan
- Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Dongqi Shen
- Hepatobiliary and Pancreatic Surgery, The First Affillated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xueying Huang
- Department of Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Qi Yu
- Department of Interventional Radiology, The First Affillated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Mei Liu
- Department of Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Feng Ren
- Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiao Wang
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Liping Dai
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Peng Wang
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hua Ye
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jianxiang Shi
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xiaoang Yang
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Shunxiang Zhang
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jianying Zhang
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
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Scheiner B, Semmler G, Maurer F, Schwabl P, Bucsics TA, Paternostro R, Bauer D, Simbrunner B, Trauner M, Mandorfer M, Reiberger T. Prevalence of and risk factors for anaemia in patients with advanced chronic liver disease. Liver Int 2020; 40:194-204. [PMID: 31444993 PMCID: PMC6973120 DOI: 10.1111/liv.14229] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 07/19/2019] [Accepted: 08/10/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Anaemia is common in advanced chronic liver disease (ACLD) as a result of various risk factors. AIMS & METHODS We evaluated the prevalence and severity of anaemia as well as the impact of anaemia on clinical outcomes in consecutive patients with ACLD and portal hypertension. RESULTS Among 494 patients, 324 (66%) patients had anaemia. Anaemic patients showed higher MELD (12 ± 4 vs 9 ± 3; P < .001), lower albumin (34 ± 6 vs 39 ± 5 g/dL; P < .001) and more often Child-Pugh B/C stage (56% vs 17%; P < .001). The prevalence of moderate-severe anaemia (haemoglobin <10 g/dL) increased with the degree of portal hypertension (HVPG: 6-9 mm Hg: 22% vs HVPG: 10-19 mm Hg: 24% vs HVPG ≥ 20 mm Hg: 36%; P = .031). The most common aetiologies of anaemia were gastrointestinal bleeding (25%) and iron deficiency (9%), while reason for anaemia remained unclear in 53% of cases. Male gender (odds ratio [OR]: 1.94 [95% CI: 1.09-3.47]; P = .025), MELD (OR: 1.20 [95% CI: 1.09-1.32]; P < .001), hepatic decompensation (OR: 4.40 [95% CI: 2.48-7.82]; P < .001) and HVPG (OR per mm Hg: 1.07 [95% CI: 1.02-1.13]; P = .004) were independent risk factors for anaemia. Anaemia was associated with hepatic decompensation (1 year: 25.1% vs 8.1%; 5 years: 60.3% vs 32.9%; P < .0001), hospitalization (73% vs 57%; P < .001) and a higher incidence rate of acute-on-chronic liver failure (0.05 [95% CI: 0.04-0.07] vs 0.03 [95% CI: 0.01-0.04]). Anaemic patients had worse overall survival (1 year: 87.1% vs 93.7%, 5 year survival: 50.5% vs 68.6%; P < .0001) and increased liver-related mortality (1 year mortality: 9.7% vs 5.7%, 5 year mortality: 38.0% vs 26.9%; P = .003). CONCLUSION Two-thirds of patients with ACLD suffer from anaemia. The degree of hepatic dysfunction and of portal hypertension correlate with severity of anaemia. Anaemia is associated with decompensation, ACLF and increased mortality in patients with ACLD.
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Affiliation(s)
- Bernhard Scheiner
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna Hepatic Hemodynamic LaboratoryMedical University of ViennaViennaAustria
| | - Georg Semmler
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna Hepatic Hemodynamic LaboratoryMedical University of ViennaViennaAustria
| | - Florian Maurer
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna Hepatic Hemodynamic LaboratoryMedical University of ViennaViennaAustria
| | - Philipp Schwabl
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna Hepatic Hemodynamic LaboratoryMedical University of ViennaViennaAustria
| | - Theresa A. Bucsics
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna Hepatic Hemodynamic LaboratoryMedical University of ViennaViennaAustria
| | - Rafael Paternostro
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna Hepatic Hemodynamic LaboratoryMedical University of ViennaViennaAustria
| | - David Bauer
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna Hepatic Hemodynamic LaboratoryMedical University of ViennaViennaAustria
| | - Benedikt Simbrunner
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna Hepatic Hemodynamic LaboratoryMedical University of ViennaViennaAustria
| | - Michael Trauner
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
| | - Mattias Mandorfer
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna Hepatic Hemodynamic LaboratoryMedical University of ViennaViennaAustria
| | - Thomas Reiberger
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna Hepatic Hemodynamic LaboratoryMedical University of ViennaViennaAustria
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Tan HK, Lee Y, Chia PY, Nurshifa SH, Tan TKC, Fook-Chong S, Chang PE, Fazila A. Translation and cultural adaption of the Chronic Liver Disease Questionnaire for the Mandarin-speaking Chinese population in Singapore through cognitive debriefing. PROCEEDINGS OF SINGAPORE HEALTHCARE 2019. [DOI: 10.1177/2010105818782710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background:Patients with chronic liver disease often suffer from poor quality of life. The Chronic Liver Disease Questionnaire (CLDQ) is a validated tool to assess health-related quality of life in these patients. It has been translated and validated for use in many countries and languages globally.Objectives:We aimed to translate Mainland Chinese Mandarin to Singapore Mandarin and perform cross-cultural adaption of CLDQ for the Mandarin-speaking population in Singapore (CLDQ-SG).Methods:This study was conducted based on the International Society for Pharmacoeconomics and Outcomes Research Principles of Good Practice. The study consisted of two parts: part one involved cognitive debriefing and cultural adaption of CLDQ, and part two was a pilot study on the first version of CLDQ-SG among adult patients with chronic liver disease in a tertiary hospital.Results:During the cognitive debriefing process of part one, questions beginning with “recent” (最近) two weeks in Mandarin were changed to “last” (在过去) two weeks. Eighteen patients were recruited for part two of the study (50% male, mean age 49±13 years). Time taken to complete CLDQ-SG was 15±8 minutes, and the mean score was 5.1±0.5. The reliability of measurements for all domains was good, with an intra-class correlation coefficient ≥0.8. Items one and four needed further restructuring. There were no discrepancies between CLDQ and CLDQ-SG.Conclusion:This study showed that CLDQ-SG was culturally acceptable by the Mandarin-speaking population in Singapore. There were only two items that needed revision in the finalized CLDQ-SG.
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Affiliation(s)
- Hiang Keat Tan
- Department of Gastroenterology and Hepatology, Division of Medicine, Singapore General Hospital, Singapore
| | - Yean Lee
- Division of Nursing, Singapore General Hospital, Singapore
| | - Pei Yuh Chia
- Division of Nursing, Singapore General Hospital, Singapore
| | | | | | - Stephanie Fook-Chong
- Health Services Research Unit, Division of Medicine, Singapore General Hospital, Singapore
| | - Pik Eu Chang
- Department of Gastroenterology and Hepatology, Division of Medicine, Singapore General Hospital, Singapore
| | - Aloweni Fazila
- Division of Nursing, Singapore General Hospital, Singapore
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Peng JK, Hepgul N, Higginson IJ, Gao W. Symptom prevalence and quality of life of patients with end-stage liver disease: A systematic review and meta-analysis. Palliat Med 2019; 33:24-36. [PMID: 30345878 PMCID: PMC6291907 DOI: 10.1177/0269216318807051] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND: End-stage liver disease is a common cause of morbidity and mortality worldwide, yet little is known about its symptomatology and impact on health-related quality of life. AIM: To describe symptom prevalence and health-related quality of life of patients with end-stage liver disease to improve care. DESIGN: Systematic review. DATA SOURCES: We searched eight electronic databases from January 1980 to June 2018 for studies investigating symptom prevalence or health-related quality of life of adult patients with end-stage liver disease. No language restrictions were applied. Meta-analyses were performed where appropriate. RESULTS: We included 80 studies: 35 assessing symptom prevalence, 41 assessing health-related quality of life, and 4 both. The instruments assessing symptoms varied across studies. The most frequently reported symptoms were as follows: pain (prevalence range 30%–79%), breathlessness (20%–88%), muscle cramps (56%–68%), sleep disturbance (insomnia 26%–77%, daytime sleepiness 29.5%–71%), and psychological symptoms (depression 4.5%–64%, anxiety 14%–45%). Erectile dysfunction was prevalent (53%–93%) in men. The health-related quality of life of patients with end-stage liver disease was significantly impaired when compared to healthy controls or patients with chronic liver disease. Compared with compensated cirrhosis, decompensation led to significant worsening of both components of the 36-Item Short Form Survey although to a larger degree for the Physical Component Summary score (decrease from average 6.4 (95% confidence interval: 4.0–8.8); p < 0.001) than for the Mental Component Summary score (4.5 (95% confidence interval: 2.4–6.6); p < 0.001). CONCLUSION: The symptom prevalence of patients with end-stage liver disease resembled that of patients with other advanced conditions. Given the diversity of symptoms and significantly impaired health-related quality of life, multidisciplinary approach and timely intervention are crucial.
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Affiliation(s)
- Jen-Kuei Peng
- 1 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.,2 Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,3 Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Nilay Hepgul
- 1 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Irene J Higginson
- 1 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Wei Gao
- 1 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
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Health-related quality of life in liver cirrhosis patients using SF-36 and CLDQ questionnaires. Clin Exp Hepatol 2018; 4:232-239. [PMID: 30603670 PMCID: PMC6311749 DOI: 10.5114/ceh.2018.80124] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 03/14/2018] [Indexed: 12/18/2022] Open
Abstract
Aim of the study To determine the factors that are likely to influence the domains of health-related quality of life (HRQOL) using SF-36 and CLDQ questionnaires in patients with liver cirrhosis. Material and methods Patients with liver cirrhosis were compared with age- and gender-matched healthy controls for physical and mental components of the SF-36 score. Effects of age, co-morbidity, namely diabetes, severity of liver disease and complications of liver cirrhosis on HRQOL using self-administered or by direct interview SF-36 and CLDQ questionnaires were studied. Statistical analysis: chi square test, ANOVA, Kruskal-Wallis test and stepwise linear regression analysis. A p value of < 0.05 was considered significant. Results Regarding SF-36 score, except for bodily pain, 149 patients had significantly low individual and composite domain scores (p value < 0.0001) compared to age/gender-matched controls. Patients below 45 years, the majority of whom belonged to Child-Turcotte-Pugh (CTP) class C with a high Model of End-Stage Liver Disease (MELD) and higher rates of complication had low SF-36 for bodily pain (KW p < 0.005) and those above 55 years for physical function (p < 0.05). Both the physical components had a major impact on mental composite score (MCS) (KW p < 0.05). The overall CLDQ score was also low in patients below 45 years old (p < 0.05). Diabetes with or without other co-morbid conditions had no effect on SF-36 or CLDQ scores, while non-diabetic co-morbid conditions did on physical domains (physical function, bodily pain and role physical) and the physical component score of SF-36 (KW p < 0.01 to < 0.0001). In linear regression, MELD had a direct and significant association with overall PCS, MCS and CLDQ. Conclusions Age below 45 years, higher MELD and CTP score with the presence of ascites and hepatic encephalopathy affect the overall CLDQ scores.
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Bihari C, Lal D, Thakur M, Sukriti S, Mathur D, Patil AG, Anand L, Kumar G, Sharma S, Thapar S, Rajbongshi A, Rastogi A, Kumar A, Sarin SK. Suboptimal Level of Bone-Forming Cells in Advanced Cirrhosis are Associated with Hepatic Osteodystrophy. Hepatol Commun 2018; 2:1095-1110. [PMID: 30202823 PMCID: PMC6128237 DOI: 10.1002/hep4.1234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/07/2018] [Indexed: 12/19/2022] Open
Abstract
Bone loss is common in advanced cirrhosis, although the precise mechanisms underlying bone loss in cirrhosis are unknown. We studied the profile and functionality of bone-forming cells and bone-building proteins in bone marrow (BM) of individuals with cirrhosis (n = 61) and individuals without cirrhosis as normal controls (n = 50). We also performed dual energy X-ray absorptiometry for clinical correlation. BM mesenchymal cells (MSCs) were analyzed for colony-forming units-fibroblasts and their osteogenic (fibronectin-1 [FN1], insulin-like growth factor binding protein 3 [IGFBP3], collagen type 1 alpha 1 chain [COL1A1], runt-related transcription factor 2 [RUNX2], and alkaline phosphatase, liver [ALPL]) and adipogenic ( adiponectin, C1Q, and collagen domain containing [ADIPOQ], peroxisome proliferator-activated receptor gamma [PPARγ], and fatty acid binding protein 4 [FABP4]) potentials. Colony-forming units-fibroblasts were lower in patients with cirrhosis (P = 0.002) than in controls. Cirrhotic BM-MSCs showed >2-fold decrease in osteogenic markers. Compared to controls, patients with cirrhosis showed fewer osteocytes (P = 0.05), osteoblasts, chondroblasts, osteocalcin-positive (osteocalcin+) area, clusters of differentiation (CD)169+ macrophages (P < 0.001, each), and nestin+ MSCs (P = 0.001); this was more apparent in Child-Turcotte-Pugh (CTP) class C than A (P < 0.001). Multivariate logistic regression showed low nestin+ MSCs (P = 0.004) as a predictor of bone loss. Bone-resolving osteoclasts were comparable among CTP groups, but >2-fold decreased anti-osteoclastic and increased pro-osteoclastic factors were noted in patients with CTP C compared to CTP A. Bone-building proteins (osteocalcin [P = 0.008], osteonectin [P < 0.001], and bone morphogenic protein 2 [P = 0.001]) were decreased while anti-bone repair factors (fibroblast growth factor 23 [P = 0.015] and dipeptidyl peptidase 4 [P < 0.001]) were increased in BM and peripheral blood; this was more apparent in advanced cirrhosis. The dual energy X-ray absorptiometry scan T score significantly correlated with the population of osteoblasts, osteocytes, MSCs, and CD169+ macrophages. Conclusion: Osteoprogenitor cells are substantially reduced in patients with cirrhosis and more so in advanced disease. Additionally, increased anti-bone repair proteins enhance the ineffective bone repair and development of osteoporosis in cirrhosis. Hepatology Communications 2018;0:0-0).
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Affiliation(s)
- Chhagan Bihari
- Department of PathologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Deepika Lal
- Department of PathologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Monika Thakur
- Department of PathologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Sukriti Sukriti
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Dhananjay Mathur
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Anupama G. Patil
- Department of PathologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Lovkesh Anand
- Department of HepatologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Guresh Kumar
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Shvetank Sharma
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Shalini Thapar
- Department of RadiologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Apurba Rajbongshi
- Department of PathologySatyavadi Raja Harish Chandra HospitalDelhiIndia
| | - Archana Rastogi
- Department of PathologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Anupam Kumar
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Shiv K. Sarin
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
- Department of HepatologyInstitute of Liver and Biliary SciencesNew DelhiIndia
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Kim HJ, Chu H, Lee S. Factors influencing on health-related quality of life in South Korean with chronic liver disease. Health Qual Life Outcomes 2018; 16:142. [PMID: 30021601 PMCID: PMC6052687 DOI: 10.1186/s12955-018-0964-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/02/2018] [Indexed: 01/12/2023] Open
Abstract
Background The objective of this study was to determine health-related quality of life (HRQoL) among chronic liver disease (CLD) subjects in South Korea using EuroQol five-dimension questionnaire (EQ-5D). Method The sample consisted of 139 subjects with CLD from the sixth Korean National Health and Nutrition Examination Survey (KNHNES VI). Data were analyzed using SPSS program for descriptive statistics, t-test, ANOVA, Scheffe’s test and hierarchical multiple regression. Results Results indicated that marital status (P < 0.01), occupation (P < 0.01), basic livelihood security recipient status (P < 0.05), hepatocellular carcinoma (P < 0.05), subjective health status (P < 0.01), and depression (P < 0.001) were significant predictors of HRQoL. Health behaviors (alcohol intake, sleep duration) variables were insignificant. Conclusion In conclusion, marital status, occupation, basic livelihood security recipient status (BLSRS), hepatocellular carcinoma (HCC), subjective health status (SHS), and depression were confirmed to be factors affecting the HRQoL. We should be provide to continuous monitoring and education of adequate alcohol intake for patients with CLD. Findings of this study might be used to develop community based health programs and policies for CLD.
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Affiliation(s)
- Hyun Jin Kim
- Department of Quality Improvement, Hanyang University Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Hyeonsik Chu
- Hanyang Cell Therapy Center, Hanyang University Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Seonhye Lee
- Department of Nursing, Gyeongnam National University of Science and Technology, 33, Dongjin-ro, Jinju-si, Gyeongsangnam-do, 52725, Republic of Korea.
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Perlin CM, Ferreira VL, Borba HHL, Wiens A, Ivantes CAP, Lenzi L, Pontarolo R. Quality of life in Brazilian patients with treated or untreated chronic hepatitis C. Rev Inst Med Trop Sao Paulo 2017; 59:e81. [PMID: 29267589 PMCID: PMC5738766 DOI: 10.1590/s1678-9946201759081] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 10/02/2017] [Indexed: 12/15/2022] Open
Abstract
Introduction: Multiple factors negatively affect the quality of life of patients infected with hepatitis C virus. This study aims to evaluate the effect of pharmacological treatment on the quality of life of these individuals. Methods: This is a cross-sectional study conducted in two Southern Brazilian centers that used two instruments (a generic and a specific one) for measuring the quality of life in patients with chronic hepatitis C: the Short Form-36 (SF-36); and the Chronic Liver Disease Questionnaire (CLDQ) for liver disease. We included patients from two centers without any treatment (control group), or receiving medication (peginterferon + ribavirin ± telaprevir or boceprevir, i.e., respectively, dual, and triple therapies). Results: One hundred and forty-seven patients were included. Patients under treatment (n = 86) had a lower score in 7 of the 8 SF-36 domains, with statistical significance (p<0.05) only for the emotional function domain. Patients who were not treated (n = 58) had higher scores in 4 of the 6 (p<0.05) CLDQ domains. A comparison of patients, receiving dual or triple therapies for both questionnaires, was only significant in the Vitality domain from CLDQ. Conclusions: Treatment can affect the subjective perception of patients regarding quality of life. Due to the complexity of the disease, each patient must be evaluated in multiple dimensions. Thus, the results may be useful for understanding the patient's perceptions during treatment, and it can also serve as a reference for care instructions.
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Affiliation(s)
- Cássio Marques Perlin
- Universidade Federal do Paraná, Programa de Pós-Graduação em Assistência Farmacêutica, Curitiba, Paraná, Brazil
| | - Vinicius Lins Ferreira
- Universidade Federal do Paraná, Programa de Pós-Graduação em Ciências Farmacêuticas, Curitiba, Paraná, Brazil
| | - Helena Hiemisch Lobo Borba
- Universidade Federal do Paraná, Programa de Pós-Graduação em Ciências Farmacêuticas, Curitiba, Paraná, Brazil
| | - Astrid Wiens
- Universidade Federal do Paraná, Programa de Pós-Graduação em Ciências Farmacêuticas, Curitiba, Paraná, Brazil
| | | | - Luana Lenzi
- Universidade Federal do Paraná, Programa de Pós-Graduação em Ciências Farmacêuticas, Curitiba, Paraná, Brazil
| | - Roberto Pontarolo
- Universidade Federal do Paraná, Programa de Pós-Graduação em Ciências Farmacêuticas, Curitiba, Paraná, Brazil
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Janani K, Varghese J, Jain M, Harika K, Srinivasan V, Michael T, Jayanthi V. HRQOL using SF36 (generic specific) in liver cirrhosis. Indian J Gastroenterol 2017; 36:313-317. [PMID: 28762138 DOI: 10.1007/s12664-017-0773-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 07/07/2017] [Indexed: 02/04/2023]
Abstract
Health-related quality of life (HRQOL) is influenced by the disease state, associated complications and their management. In patients with liver cirrhosis co-morbidity, severity of liver disease and their complications are likely to affect the QOL. The aim of the study was to determine the factors that are likely to influence the domains of HRQOL using SF-36 in patients with liver cirrhosis. For the study, 149 patients with liver cirrhosis were compared with age-gender matched healthy controls for physical and mental components of SF-36 score and the effects of age, co-morbidity severity of liver disease and complications of liver cirrhosis on HRQOL were assessed using the same questionnaire. Results of the study showed that except for body pain, all the patients had a significantly low individual and composite domain score (p-value <0.0001) compared to age-gender matched controls. Patients below 45 years, Child-Turcotte-Pugh (CTP) C, a high model for end-stage liver disease (MELD) and higher rates of complication had low scores for body pain (KW p <0.005) and those above 55 years, for physical function (p <0.05). Both the physical components had a major impact on mental composite score (MCS) (KW p <0.05). Co-morbidity that included diabetes, hypertension and hypothyroid states in various combinations had no effect on SF-36 scores while co-morbid conditions like musculoskeletal pain, arthralgia etc. affected physical domains (physical function, body pain and role physical) and physical component score (PCS) (KW p <0.01 to <0.0001). By linear regression, MELD had a direct and significant association with overall PCS and mental component score (MCS).
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Affiliation(s)
- K Janani
- Department of Gastroenterology, Gleneagles Global Health City, 439, Cheran Nagar, Chennai, 600 100, India
| | - Joy Varghese
- Institute of Liver Disease and Transplantation, Gleneagles Global Health City, 439, Cheran Nagar, Chennai, 600 100, India
| | - Mayank Jain
- Department of Gastroenterology, Gleneagles Global Health City, 439, Cheran Nagar, Chennai, 600 100, India
| | - Kavya Harika
- Institute of Liver Disease and Transplantation, Gleneagles Global Health City, 439, Cheran Nagar, Chennai, 600 100, India
| | - Vijaya Srinivasan
- Department of Gastroenterology, Gleneagles Global Health City, 439, Cheran Nagar, Chennai, 600 100, India
| | - Tom Michael
- Department of Gastroenterology, Gleneagles Global Health City, 439, Cheran Nagar, Chennai, 600 100, India
| | - Venkataraman Jayanthi
- Department of Gastroenterology, Gleneagles Global Health City, 439, Cheran Nagar, Chennai, 600 100, India.
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Salama ZA, Darweesh SK, Shehab HM, Abd-Elhameed MA. Etiology and prevalence of fatigue in chronic liver disease: clinical view. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2016. [DOI: 10.4103/1110-7782.193892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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13
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Karacaer Z, Cakir B, Erdem H, Ugurlu K, Durmus G, Ince NK, Ozturk C, Hasbun R, Batirel A, Yilmaz EM, Bozkurt I, Sunbul M, Aynioglu A, Atilla A, Erbay A, Inci A, Kader C, Tigen ET, Karaahmetoglu G, Coskuner SA, Dik E, Tarakci H, Tosun S, Korkmaz F, Kolgelier S, Karadag FY, Erol S, Turker K, Necan C, Sahin AM, Ergen P, Iskender G, Korkmaz P, Eroglu EG, Durdu Y, Ulug M, Deniz SS, Koc F, Alpat SN, Oztoprak N, Evirgen O, Sozen H, Dogan M, Kaya S, Kaya S, Altindis M, Aslan E, Tekin R, Sezer BE, Ozdemir K, Ersoz G, Sahin A, Celik I, Aydin E, Bastug A, Harman R, Ozkaya HD, Parlak E, Yavuz I, Sacar S, Comoglu S, Yenilmez E, Sirmatel F, Balkan II, Alpay Y, Hatipoglu M, Denk A, Senol G, Bitirgen M, Geyik MF, Guner R, Kadanali A, Karakas A, Namiduru M, Udurgucu H, Boluktas RP, Karagoz E, Ormeci N. Quality of life and related factors among chronic hepatitis B-infected patients: a multi-center study, Turkey. Health Qual Life Outcomes 2016; 14:153. [PMID: 27809934 PMCID: PMC5095975 DOI: 10.1186/s12955-016-0557-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 10/21/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The aim of this study was to assess health-related quality of life (HRQOL) among chronic hepatitis B (CHB) patients in Turkey and to study related factors. METHODS This multicenter study was carried out between January 01 and April 15, 2015 in Turkey in 57 centers. Adults were enrolled and studied in three groups. Group 1: Inactive HBsAg carriers, Group 2: CHB patients receiving antiviral therapy, Group 3: CHB patients who were neither receiving antiviral therapy nor were inactive HBsAg carriers. Study data was collected by face-to-face interviews using a standardized questionnaire, Short Form-36 (SF-36) and Hepatitis B Quality of Life (HBQOL). Values equivalent to p < 0.05 in analyses were accepted as statistically significant. RESULTS Four thousand two hundred fifty-seven patients with CHB were included in the study. Two thousand five hundred fifty-nine (60.1 %) of the patients were males. Groups 1, 2 and 3, consisted of 1529 (35.9 %), 1721 (40.4 %) and 1007 (23.7 %) patients, respectively. The highest value of HRQOL was found in inactive HBsAg carriers. We found that total HBQOL score increased when antiviral treatment was used. However, HRQOL of CHB patients varied according to their socio-demographic properties. Regarding total HBQOL score, a higher significant level of HRQOL was determined in inactive HBV patients when matched controls with the associated factors were provided. CONCLUSIONS The HRQOL score of CHB patients was higher than expected and it can be worsen when the disease becomes active. Use of an antiviral therapy can contribute to increasing HRQOL of patients.
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Affiliation(s)
- Zehra Karacaer
- Department of Infectious Diseases and Clinical Microbiology, Etimesgut Military Hospital, Ankara, Turkey.
| | - Banu Cakir
- Institute of Public Health, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hakan Erdem
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Medical Academy, Ankara, Turkey
| | - Kenan Ugurlu
- Department of Infectious Diseases and Clinical Microbiology, 25 Aralık State Hospital, Gaziantep, Turkey
| | - Gul Durmus
- Department of Infectious Diseases and Clinical Microbiology, Sevket Yilmaz Training and Research Hospital, Bursa, Turkey
| | - Nevin Koc Ince
- Department of Infectious Diseases and Clinical Microbiology, Duzce University School of Medicine, Duzce, Turkey
| | - Cinar Ozturk
- Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey
| | - Rodrigo Hasbun
- Department of Infectious Diseases, The University of Texas Health Science Center at Houston, Medical School, Houston, TX, USA
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
| | - Esmeray Mutlu Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ilkay Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Mustafa Sunbul
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Aynur Aynioglu
- Department of Infectious Diseases and Clinical Microbiology, Ataturk State Hospital, Zonguldak, Turkey
| | - Aynur Atilla
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ayse Erbay
- Department of Infectious Diseases and Clinical Microbiology, Bozok University School of Medicine, Yozgat, Turkey
| | - Ayse Inci
- Department of Infectious Diseases and Clinical Microbiology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Cigdem Kader
- Department of Infectious Diseases and Clinical Microbiology, Bozok University School of Medicine, Yozgat, Turkey
| | - Elif Tukenmez Tigen
- Department of Infectious Diseases and Clinical Microbiology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Gokhan Karaahmetoglu
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Medical Academy Haydarpasa Training and Research Hospital, Istanbul, Turkey
| | - Seher Ayten Coskuner
- Department of Infectious Diseases and Clinical Microbiology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Ebru Dik
- Department of Infectious Diseases and Clinical Microbiology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Huseyin Tarakci
- Department of Infectious Diseases and Clinical Microbiology, Izmir Metropolitan Municipalities Esrefpasa Hospital, Izmir, Turkey
| | - Selma Tosun
- Department of Infectious Diseases and Clinical Microbiology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Fatime Korkmaz
- Department of Infectious Diseases and Clinical Microbiology, Konya Training and Research Hospital, Konya, Turkey
| | - Servet Kolgelier
- Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Fatma Yilmaz Karadag
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Serpil Erol
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Kamuran Turker
- Department of Infectious Diseases and Clinical Microbiology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ceyda Necan
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Ahmet Melih Sahin
- Department of Infectious Diseases and Clinical Microbiology, Giresun State Hospital, Giresun, Turkey
| | - Pinar Ergen
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Gulsen Iskender
- Department of Infectious Diseases and Clinical Microbiology, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Pinar Korkmaz
- Department of Infectious Diseases and Clinical Microbiology, Dumlupinar University Evliya Celebi Training and Research Hospital, Kutahya, Turkey
| | - Esma Gulesen Eroglu
- Department of Infectious Diseases and Clinical Microbiology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Yasemin Durdu
- Department of Infectious Diseases and Clinical Microbiology, Eyup State Hospital, Istanbul, Turkey
| | - Mehmet Ulug
- Department of Infectious Diseases and Clinical Microbiology, Umit Hospital, Eskisehir, Turkey
| | - Suna Secil Deniz
- Department of Infectious Diseases and Clinical Microbiology, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Filiz Koc
- Department of Infectious Diseases and Clinical Microbiology, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Saygın Nayman Alpat
- Department of Infectious Diseases and Clinical Microbiology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Nefise Oztoprak
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Omer Evirgen
- Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University School of Medicine, Hatay, Turkey
| | - Hamdi Sozen
- Department of Infectious Diseases and Clinical Microbiology, Sitki Kocman University School of Medicine, Mugla, Turkey
| | - Mustafa Dogan
- Department of Infectious Diseases and Clinical Microbiology, Corlu State Hospital, Tekirdag, Turkey
| | - Selcuk Kaya
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Safak Kaya
- Department of Infectious Diseases and Clinical Microbiology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Mustafa Altindis
- Department of Clinical Microbiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Emel Aslan
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Busra Ergut Sezer
- Department of Infectious Diseases and Clinical Microbiology, Corlu State Hospital, Tekirdag, Turkey
| | - Kevser Ozdemir
- Department of Infectious Diseases and Clinical Microbiology, Denizli State Hospital, Denizli, Turkey
| | - Gulden Ersoz
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - Ahmet Sahin
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Ilhami Celik
- Department of Infectious Diseases and Clinical Microbiology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Emsal Aydin
- Department of Infectious Diseases and Clinical Microbiology, Kafkas University School of Medicine, Kars, Turkey
| | - Aliye Bastug
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Rezan Harman
- Department of Infectious Diseases and Clinical Microbiology, Sani Konukoglu Hospital, Gaziantep, Turkey
| | - Hacer Deniz Ozkaya
- Department of Infectious Diseases and Clinical Microbiology, Karsıkaya State Hospital, Izmir, Turkey
| | - Emine Parlak
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Ilknur Yavuz
- Department of Infectious Diseases and Clinical Microbiology, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Suzan Sacar
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Senol Comoglu
- Department of Infectious Diseases and Clinical Microbiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Ercan Yenilmez
- Department of Infectious Diseases and Clinical Microbiology, Kasimpasa Military Hospital, Istanbul, Turkey
| | - Fatma Sirmatel
- Department of Infectious Diseases and Clinical Microbiology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey
| | - Ilker Inanc Balkan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Yesim Alpay
- Department of Infectious Diseases and Clinical Microbiology, Balikesir University School of Medicine, Balikesir, Turkey
| | - Mustafa Hatipoglu
- Department of Infectious Diseases and Clinical Microbiology, Canakkale Military Hospital, Canakkale, Turkey
| | - Affan Denk
- Department of Infectious Diseases and Clinical Microbiology, Firat University School of Medicine, Elazig, Turkey
| | - Gunes Senol
- Department of Infectious Diseases and Clinical Microbiology, Izmir Dr. Suat Seren Pulmonology and Pulmonary Surgery Training and Research Hospital, Izmir, Turkey
| | - Mehmet Bitirgen
- Department of Infectious Diseases and Clinical Microbiology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Mehmet Faruk Geyik
- Department of Infectious Diseases and Clinical Microbiology, Duzce University School of Medicine, Duzce, Turkey
| | - Rahmet Guner
- Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Ayten Kadanali
- Department of Infectious Diseases and Clinical Microbiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Karakas
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Medical Academy, Ankara, Turkey
| | - Mustafa Namiduru
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Hatice Udurgucu
- Department of Infectious Diseases and Clinical Microbiology, Firat University School of Medicine, Elazig, Turkey
| | - Rukiye Pinar Boluktas
- Faculty of Health Sciences, Department of Nursing, Selahaddin Eyyubi University, Diyarbakir, Turkey
| | - Ergenekon Karagoz
- Department of Infectious Diseases and Clinical Microbiology, Van Military Hospital, Van, Turkey
| | - Necati Ormeci
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
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Šumskienė J, Kupčinskas L, Šumskas L. Health-related quality of life measurement in chronic liver disease patients. MEDICINA-LITHUANIA 2015; 51:201-8. [PMID: 26424183 DOI: 10.1016/j.medici.2015.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 06/13/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Health-related quality of life (HRQOL) is an important health indicator in medical outcome research and clinical practice. This issue tends to attract even more attention with the recent improvements of patient survival after liver transplantation. This review article aims at providing a deeper insight into practices used for evaluating HRQOL in chronic liver diseases (CLDs) and especially cirrhosis patients during different stages of the disease including liver transplantation. MATERIALS AND METHODS A systematic review of the MEDLINE database and Cochrane library was conducted. A search using the Medical Subject Headings (MeSH) major terms "liver disease" AND "quality of life" was applied for the period from 1966 to 2012. RESULTS Our review identified 1483 publications. The searched showed that significant increase of publications (from 362 to 1018) was observed during last decade (period 2003-2012) in comparison with previous. The majority of publications were in English (n=1179). The literature search and analysis provided information on the most common generic and disease-specific HRQOL instruments, which are used in CLD patients: Medical Outcomes Study Short Form-36, the National Institute of Diabetes and Digestive and Kidney Diseases Quality of Life questionnaire, the Chronic Liver Disease questionnaire, the Liver Disease Quality of Life questionnaire, and other. CONCLUSIONS Quality of life instruments are potentially powerful tools for evaluating the functional status, presenting gains of treatment and reflecting patients' ability to return to a normal lifestyle in CLD patients. More attention should be paid by clinicians for integrated use of clinical tests together with HRQOL instruments in liver transplantation for establishing the reference levels of mental, physical, and role-social functioning.
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Affiliation(s)
- Jolanta Šumskienė
- Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Limas Kupčinskas
- Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Linas Šumskas
- Department of Preventive Medicine, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute of Health Research, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
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Deng WJ, Zhang HR, Li HY, Shi W. Factors associated with quality of life in patients with cirrhosis. Shijie Huaren Xiaohua Zazhi 2015; 23:2729-2735. [DOI: 10.11569/wcjd.v23.i17.2729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate and evaluate the factors related to the quality of life in patients with cirrhosis.
METHODS: The quality of life for 214 cirrhosis patients treated at our hospital was assessed using the Chinese version of Medical Outcomes Study Short Form-36 (SF-36) questionnaire. Relevant clinical data for patients were also collected to conduct univariate analysis and multivariate stepwise regression analysis.
RESULTS: Univariate analysis showed that factors affecting the quality of life in all dimensions in patients with cirrhosis were percentage of treatment costs accounting for family income, fatigue, anorexia, dizziness, family economic burden, anxiety and depression (P < 0.05). Multivariate linear regression analysis demonstrated that age, dizziness, loss of appetite, anxiety, depression, and family economic burden significantly affect the quality of life scores in patients with cirrhosis (P < 0.05).
CONCLUSION: The factors influencing the quality of life in patients with cirrhosis are complex and multifactorial.
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Popovic DD, Kovacevic NV, Kisic Tepavcevic DB, Trajkovic GZ, Alempijevic TM, Spuran MM, Krstic MN, Jesic RS, Younossi ZM, Pekmezovic TD. Validation of the chronic liver disease questionnaire in Serbian patients. World J Gastroenterol 2013; 19:4950-4957. [PMID: 23946600 PMCID: PMC3740425 DOI: 10.3748/wjg.v19.i30.4950] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 06/05/2013] [Accepted: 06/20/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To translate into Serbian and to investigate the validity of the cross-culturally adapted the chronic liver disease questionnaire (CLDQ).
METHODS: The questionnaire was validated in 103 consecutive CLD patients treated between October 2009 and October 2010 at the Clinic for Gastroenterology, Clinical Centre of Serbia, Belgrade (Serbia). Exclusion criteria were: age < 18 years, psychiatric disorders, acute complications of CLD (acute liver failure, variceal bleeding, and spontaneous bacterial peritonitis), hepatic encephalopathy (grade > 2) and liver transplantation. Evaluation of the CLDQ was done based on the following parameters: (1) acceptance is shown by the proportion of missing items; (2) internal reliabilities were assessed for multiple item scales by using Cronbach alpha coefficient; and (3) in order to assess whether the allocation of items in the domain corresponds to their distribution in the original questionnaire (construction validity), an exploratory factor analysis was conducted. Discriminatory validity was determined by comparing the corresponding CLDQ score/sub-score in patients with different severity of the diseases.
RESULTS: The Serbian version of CLDQ questionnaire completed 98% patients. Proportion of missing items was 0.06%. The total time needed to fill the questionnaire was ranged from 8 to 15 min. Assistance in completing the questionnaire required 4.8% patients, while 2.9% needed help in reading, and 1.9% involved writing assistance. The mean age of the selected patients was 53.8 ± 12.9 years and 54.4% were men. Average CLDQ score was 4.62 ± 1.11. Cronbach’s alpha for the whole scale was 0.93. Reliability for all domains was above 0.70, except for the domain “Activity” (0.49). The exploratory factor analysis model revealed 6 factors with eigenvalue of greater than 1, explaining 69.7% of cumulative variance. The majority of the items (66%) in the Serbian version of the CLDQ presented the highest loading weight in the domain assigned by the CLDQ developers: “Fatigue” (5/5), “Emotional function” (6/8), “Worry” (5/5), “Abdominal symptoms” (0/3), “Activity” (0/3), “Systemic symptoms” (3/5). The scales “Fatigue” and “Worry” fully corresponded to the original. The factor analysis also revealed that the factors “Activity” and “Abdominal symptoms” could not be replicated, and two new domains “Sleep” and “Nutrition” were established. Analysis of the CLDQ score/sub-score distribution according to disease severity demonstrated that patients without cirrhosis had lower total CLDQ score (4.86 ± 1.05) than those with cirrhosis Child’s C (4.31 ± 0.97). Statistically significant difference was detected for the domains “Abdominal symptoms” [F (3) = 5.818, P = 0.001] and “Fatigue” [F (3) = 3.39, P = 0.021]. Post hoc analysis revealed that patients with liver cirrhosis Child’s C had significantly lower sub-score “Abdominal symptoms” than patients without cirrhosis or liver cirrhosis Child’s A or B. For domain “Fatigue”, patients with cirrhosis Child’s C had significantly lower score, than non-cirrhotic patients.
CONCLUSION: The Serbian version of CLDQ is well accepted and represents a valid and reliable instrument in Serbian sample of CLD patients.
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Health-related quality of life and survival in Chinese patients with chronic liver disease. Health Qual Life Outcomes 2013; 11:131. [PMID: 23902894 PMCID: PMC3734055 DOI: 10.1186/1477-7525-11-131] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Accepted: 07/30/2013] [Indexed: 12/20/2022] Open
Abstract
Background To investigate the relationship between health-related quality of life (HRQOL) and survival in Chinese patients with chronic liver disease (CLD). Methods HRQOL was measured with the Chinese version of Short Form 36 (SF-36). SF-36 scores, demographic and clinical data were collected at baseline and after 18 months follow-up. Kaplan-Meier and Cox Proportional Hazard Regression survival analyses were used for interpretation of data. Surviving patients were censored in the analyses. Results A total of 415 Chinese patients with CLD and 86 healthy controls were enrolled. During the follow-up period 50 patients died. SF-36 scores in healthy controls and surviving patients were higher compared with those in deceased patients. Scores of physical component summary (PCS) in healthy controls, surviving and deceased patients were 54.1 ± 5.2, 48.9 ± 7.7 and 33.5 ± 8.2 respectively (p < 0.001). Scores of mental component summary (MCS) in healthy controls, surviving and deceased patients were 56.6 ± 8.2, 53.0 ± 5.6 and 37.1 ± 12.1 (p < 0.001) respectively. Survival was significantly associated with PCS and MCS scores, and the presence of ascites. Conclusions HRQOL was associated with survival in patients with CLD. PCS and MCS scores were predictors of survival.
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