Abstract
BackgroundThe symptoms and complications related to chronic liver disease (CLD) have been shown to affect patient well-being. Currently there is limited research data on how CLD severity may affect both health-related quality of life (HRQOL) and the development of depressive symptoms in CLD patients. Moreover, the ongoing advances in CLD treatment, and its effect on HRQOL, highlight the need for further studies. Therefore, the aim of the present study was to evaluate if the CLD severity may affect the HRQOL and the development of depressive symptoms.MethodsA cross-sectional study was conducted. Patients with CLDs were identified at their regular visits to the outpatient clinic of the Sant’Orsola-Malpighi Hospital in Bologna, between September 2016 and July 2017. HRQOL was measured with Short Form 12 (SF-12) and Nottingham Health Profile (NHP) questionnaires; depressive symptoms were measured with Beck Depression Inventory-II (BDI). CLD severity was measured using the MELD score and the sample was stratified into five classes according to it. Group comparisons were conducted using the Kruskal–Wallis test.ResultsTwo hundred and fifty-four patients were included. Mean age was 62.84 years (SD 11.75) and 57.9% were male. Most participants were affected by compensated cirrhosis (140.2%) and chronic hepatitis (40.2%), with a disease duration ≥ 5 years (69.3%). Regarding the MELD score, 67.7% of patients belonged to Class I, 29.9% to Class II, and 2.4% to Class III. There were not patients belonging to the Classes IV and V.No statistically significant differences were found in all SF-12 and NHP domains between the MELD classes, except for CLD impact on sexual life and holidays (p = 0.037 and p = 0.032, respectively). A prevalence rate of 26% of depressive symptoms was reported, no statistically significant differences were found in BDI-II total scores between the three MELD classes.ConclusionsAll domains of HRQOL and depression were altered in CLDs patients, nevertheless CLD severity was not confirmed as an affecting factor for HRQOL.
Highlights
The symptoms and complications related to chronic liver disease (CLD) have been shown to affect patient well-being
All domains of health-related quality of life (HRQOL) and depression were altered in CLDs patients, CLD severity was not confirmed as an affecting factor for HRQOL
The disease manifestations related to cirrhosis and other CLDs, such as ascites, hepatic encephalopathy, recurrent variceal bleeding, fatigue, joint pain, abdominal pain, muscle cramps, skin itching, loss of appetite, depression and anxiety, have been shown to negatively affect patient well-being and health-related quality of life (HRQOL) [1, 2, 10, 11]
Summary
The symptoms and complications related to chronic liver disease (CLD) have been shown to affect patient well-being. There is limited research data on how CLD severity may affect both health-related quality of life (HRQOL) and the development of depressive symptoms in CLD patients. The aim of the present study was to evaluate if the CLD severity may affect the HRQOL and the development of depressive symptoms. The disease manifestations related to cirrhosis and other CLDs, such as ascites, hepatic encephalopathy, recurrent variceal bleeding, fatigue, joint pain, abdominal pain, muscle cramps, skin itching, loss of appetite, depression and anxiety, have been shown to negatively affect patient well-being and health-related quality of life (HRQOL) [1, 2, 10, 11].
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