%0 Journal Article
%T Predictors of Health-Related Quality of Life in Outpatients with Cirrhosis: Results from a Prospective Cohort
%A Maja Thiele
%A Gro Askgaard
%A Hans B. Timm
%A Ole Hamberg
%A Lise L. Gluud
%J Hepatitis Research and Treatment
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/479639
%X Background. Cirrhosis may lead to a poor health-related quality of life (HRQOL), which should be taken into consideration when addressing the cirrhotic outpatient. Methods. Prospective cohort study evaluating predictors of HRQOL in outpatients with cirrhosis. Patients with overt hepatic encephalopathy at baseline were excluded. HRQOL was evaluated at baseline using the six point Chronic Liver Disease Questionnaire. Predictors of low quality of life scores (<4 points) and mortality were analyzed using multivariable logistic regression. Results. In total, 92 patients were included (mean age 61 years, 59% male). Nineteen patients died (mean duration of follow-up 20 months). The mean Child-Pugh score was 6.9. Twenty percent had a poor HRQOL judged by the Chronic Liver Disease Questionnaire score and 45% had covert hepatic encephalopathy. The only predictors of poor HRQOL were the Child-Pugh score ( ), nonalcoholic etiology of cirrhosis ( ), and body mass index ( ). The body mass index predicted poor HRQOL independently of the presence of ascites and albumin level. Conclusions. The body mass index was associated with a low HRQOL. This suggests that malnutrition may be an important target in the management of patients with cirrhosis. 1. Introduction The prognosis of cirrhosis has improved following the development of a number of effective interventions [1¨C3]. The improvements include the management of gastrointestinal bleeding, hepatorenal syndrome, spontaneous bacterial peritonitis, hepatocellular carcinoma, and hepatic encephalopathy (HE) [4¨C8]. The health-related quality of life (HRQOL) is therefore becoming increasingly important [9¨C13]. Most quality of life studies have used generic questionnaires, which allow for comparisons between different groups of patients. These questionnaires will provide an overall picture of the wellbeing of participants. Patients with cirrhosis have specific somatic and cognitive symptoms that may affect their HRQOL [12, 14, 15]. These symptoms may not be captured by generic scales [9, 13, 16, 17]. Questionnaires specifically for patients with chronic liver disease have therefore been developed [14, 18]. Identifying factors associated with HRQOL may help improve patient care and guide future research [12]. This is especially the case for long-term care in an outpatient setting. We therefore performed a prospective cohort study aimed at investigating the prognosis and predictors of HRQOL in patients with cirrhosis followed up at an outpatient setting. 2. Materials and Methods 2.1. Included Subjects From February 2008 to May
%U http://www.hindawi.com/journals/heprt/2013/479639/