Predictors of Health Related Quality of Life in Patients with Liver Cirrhosis in Patients with Liver Cirrhosis at Tertiary Care Hospital Karachi

Abstract

Purpose: Chronic Liver Disease/cirrhosis (CLD) in individuals produces variety of symptoms which in turn lead to a negative impact on Health Related Quality of Life (HRQOL). However, no such work has been carried out in Pakistan. The general aim of this study was to evaluate the magnitude of poor HRQOL and to assess factors related with HRQOL in patients with CLD. Methods: A cross sectional study conducted at Gastroenterology clinics of AKUH. All adult patients diagnosed to have cirrhosis were invited to participate. In this study Chronic Liver Disease Questionnaire (CLDQ) was used to assess HRQOL of these patients. Patients were categorized into two groups based on CLDQ score; <5 as poor and >5 as good score for determination of frequency of poor HRQOL. CLDQ score was used as an outcome measure to determine factors related with HRQOL. Results: 273 participants were recruited; 155 (57%) were males. Mean age of participants was 49 years (SD±11years). In this study the most common cause for cirrhosis was viral infection 247(91.5%). Mean Child Turcot Pugh (CTP) score was 8±1.85 and mean (MELD) score was 12.6± 6.8. Two thirds of patients 209 (76.6%) had CTP B or C stage. Poor HRQOL was seen in 187(69%) of the participants. Mean CLDQ score was 4.36 (SD±1.1). Amongst all of the domains, fatigue domain had significantly lower CLDQ score. On multivariable analysis Hemoglobin (β=0.09 [SE=0.04]), Albumin (β=0.32[SE=0.09]), Diastolic Blood Pressure (DBP) (β=0.01[0.005) prior history of decompensation (β=0.98[SE=0.39] were significant factors associated with HRQOL in patients with liver cirrhosis. Conclusion: Frequency of poor HRQOL determined by CLDQ score is high in patients with liver cirrhosis. Hemoglobin, serum albumen, prior history of decompensation are associated with HRQOL.