Health-related quality of life and survival in Chinese patients with chronic liver disease
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RESEARCH
Open Access
Health-related quality of life and survival in Chinese patients with chronic liver disease Feng Gao, Ru Gao, Guang Li, Zhan Min Shang and Jian Yu Hao*
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. Keywords: Health-related quality of life, Chronic liver disease, SF-36, Survival
Introduction Chronic liver disease (CLD) is known to cause significant morbidity and mortality, typically due to a number of complications that include ascites, hepatic encephalopathy, variceal hemorrhage and hepatorenal syndrome [1,2]. CLD negatively impacts health-related quality of life (HRQL) [3-6] with patients suffering from fatigue, loss of self-esteem, an inability to function at work, anxiety, depression and other emotional problems that profoundly decrease their quality of life and well-being [7-13]. Although recent research shows that HRQOL scores are independent prognostic factors for overall survival in patients with unresectable hepatocellular carcinoma (HCC) and can predict survival in liver transplant candidates [14-17], the relationship between HRQOL and survival in patients with CLD remains unclear. Therefore, the aim of this study was to examine whether scores from the Short Form 36 (SF-36) health survey are able to predict survival in Chinese patients with CLD. * Correspondence: [email protected] Digestive Department, Beijing Chao-Yang Hospital, Capital Medical University, No.8 Gong Ren Ti Yu Chang Nan Road, Chao Yang District, Beijing 100020, China
Methods Ethics
The study received ethics approval from the Ethics Board of Beijing Chao-Yang Hospital, Capital Medical University and all participants gave written informed consent.
Patient selection
Between September 2009 and September 2011, eligible patients with CLD, aged 18 to 80 years from the Digestive Department of Be
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