Liver transplant candidates have impaired quality of life across health domains as assessed by computerized testing
| Autor: | Alex Zimmet, George J. Stukenborg, Jonathan G. Stine, Alden Adkins, Curtis K. Argo, Jennifer Wang, Blake Niccum |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis Waiting Lists medicine.medical_treatment Specialties of internal medicine Pilot Projects Anxiety Liver transplantation Severity of Illness Index Article End Stage Liver Disease 03 medical and health sciences Liver disease Cognition 0302 clinical medicine Quality of life Internal medicine Activities of Daily Living medicine Humans Medical history Patient Reported Outcome Measures Hepatic encephalopathy Patient reported outcomes Fatigue Hepatology Depression business.industry Role General Medicine Hepatitis C Middle Aged Social Participation medicine.disease Liver Transplantation RC581-951 Hepatic Encephalopathy 030220 oncology & carcinogenesis Quality of Life Female 030211 gastroenterology & hepatology Sleep business Software |
| Zdroj: | Annals of Hepatology, Vol 19, Iss 1, Pp 62-68 (2020) Annals of hepatology |
| ISSN: | 1665-2681 |
| Popis: | Introduction and objectives Liver transplantation candidates are among the most comorbid patients awaiting lifesaving intervention. Health related quality of life (HRQOL) measured by instruments that incorporate dynamic computerized adaptive testing, could improve their assessment. We aimed to determine the feasibility of administration of the Patient-Reported Outcomes Measurement Information System (PROMIS-CAT) in liver transplant candidates. Materials and methods Liver transplantation candidates were prospectively enrolled following a review of their available medical history. Subjects were given a tablet computer (iPad) to access the pre-loaded PROMIS CAT. Results 109 candidates with mean age 55.6 ± 8.6 years were enrolled in this pilot study. Mean MELD-Na score was 16.3 ± 6.3; 92.6% had decompensated liver disease. Leading etiologies of cirrhosis included hepatitis C (34.8%), nonalcoholic steatohepatitis (25.7%) and alcohol (21.1%). Subjects with MELD-Na score > 20 had the most significant impairment in HRQOL (anxiety/fear + 5.9 ± 2.7, p = 0.0289, depression + 5.1 ± 2.5, p = 0.0428, fatigue + 4.3 ± 2.6, p = 0.0973) and physical impairment (−7.8 ± 2.5, p = 0.0022). Stage of cirrhosis and decompensated liver disease were predictive of impaired HRQOL but Child–Pugh Turcotte score was not. Hepatic encephalopathy was the strongest independent predictor of impaired HRQOL, with significant impairment across all domains of health. Conclusions Liver transplant candidates have significantly impaired HRQOL across multiple domains of health as measured by PROMIS-CAT. HRQOL impairment parallels disease severity. Future study is needed to determine how best HRQOL could be systematically included in liver transplantation listing policy, especially in those candidates with hepatic encephalopathy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|