R A Bhanji1, E J Carey2, K D Watt1. 1. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. 2. Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, USA.
Abstract
BACKGROUND: With recent advances in the management of chronic liver disease and its complications, the long-term survival in cirrhosis has improved. Therefore, the number of individuals who will spend a significant proportion of their life with end-stage liver disease (ESLD) may continue to rise. Thus, more attention to quality of life (QOL) and its integration with traditional clinical endpoints is needed. AIMS: Recently, there have been many studies looking at treatment outcomes and their impact on the QOL in patients with ESLD. The aim of this review was to summarise and compare the insights gained from these intervention studies and to make concise recommendations to further promote and improve QOL in this patient population. METHODS: A literature search was conducted using PubMed and Web of Science. Search terms "Quality of life" "Cirrhosis" and "end-stage liver disease" were used as MeSH terms or searched in the title of the article. RESULTS: These studies uniformly show significant improvement in health-related QOL (HRQOL) with management of malnutrition, hepatic encephalopathy and ascites. Thus, early recognition and management of these complications are keys to better serve our patients. Early involvement of palliative care also leads to improved quality of end-of-life care. CONCLUSIONS: Complications of cirrhosis including malnutrition, encephalopathy, ascites and variceal bleeding lead to a decrease in HRQOL. Assessment of HRQOL has an important implication for the patient. The findings of this review illuminate the importance of using consistent tools to accurately assess QOL in patients with ESLD.
BACKGROUND: With recent advances in the management of chronic liver disease and its complications, the long-term survival in cirrhosis has improved. Therefore, the number of individuals who will spend a significant proportion of their life with end-stage liver disease (ESLD) may continue to rise. Thus, more attention to quality of life (QOL) and its integration with traditional clinical endpoints is needed. AIMS: Recently, there have been many studies looking at treatment outcomes and their impact on the QOL in patients with ESLD. The aim of this review was to summarise and compare the insights gained from these intervention studies and to make concise recommendations to further promote and improve QOL in this patient population. METHODS: A literature search was conducted using PubMed and Web of Science. Search terms "Quality of life" "Cirrhosis" and "end-stage liver disease" were used as MeSH terms or searched in the title of the article. RESULTS: These studies uniformly show significant improvement in health-related QOL (HRQOL) with management of malnutrition, hepatic encephalopathy and ascites. Thus, early recognition and management of these complications are keys to better serve our patients. Early involvement of palliative care also leads to improved quality of end-of-life care. CONCLUSIONS: Complications of cirrhosis including malnutrition, encephalopathy, ascites and variceal bleeding lead to a decrease in HRQOL. Assessment of HRQOL has an important implication for the patient. The findings of this review illuminate the importance of using consistent tools to accurately assess QOL in patients with ESLD.
Authors: Maria Stepanova; Fatema Nader; Christophe Bureau; Danielle Adebayo; Laure Elkrief; Dominique Valla; Markus Peck-Radosavljevic; Anne McCune; Victor Vargas; Macarena Simon-Talero; Juan Cordoba; Paolo Angeli; Silvia Rossi; Stewart MacDonald; Jeroen Capel; Rajiv Jalan; Zobair M Younossi Journal: Qual Life Res Date: 2018-02-19 Impact factor: 4.147
Authors: Barbara Kimbell; Scott A Murray; Heidi Byrne; Andrea Baird; Peter C Hayes; Alastair MacGilchrist; Anne Finucane; Patricia Brookes Young; Ronan E O'Carroll; Christopher J Weir; Marilyn Kendall; Kirsty Boyd Journal: Palliat Med Date: 2018-03-08 Impact factor: 4.762