Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Liver Transpl. 2010 Feb;16(2):238-45. doi: 10.1002/lt.21984.
Health-related quality of life (HRQOL) is an important measure of the effects of chronic liver disease in affected patients that helps guide interventions to improve well-being. However, the relationship between HRQOL and survival in liver transplant candidates remains unclear. We examined whether the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores from the Short Form 36 (SF-36) Health Survey were associated with survival in liver transplant candidates. We administered the SF-36 questionnaire (version 2.0) to patients in the Pulmonary Vascular Complications of Liver Disease study, a multicenter prospective cohort of patients evaluated for liver transplantation in 7 academic centers in the United States between 2003 and 2006. Cox proportional hazards models were used with death as the primary outcome and adjustment for liver transplantation as a time-varying covariate. The mean age of the 252 participants was 54 +/- 10 years, 64% were male, and 94% were white. During the 422 person years of follow-up, 147 patients (58%) were listed, 75 patients (30%) underwent transplantation, 49 patients (19%) died, and 3 patients were lost to follow-up. Lower baseline PCS scores were associated with an increased mortality rate despite adjustments for age, gender, Model for End-Stage Liver Disease score, and liver transplantation (P for the trend = 0.0001). The MCS score was not associated with mortality (P for the trend = 0.53). In conclusion, PCS significantly predicts survival in liver transplant candidates, and interventions directed toward improving the physical status may be helpful in improving outcomes in liver transplant candidates.
健康相关生活质量（HRQOL）是衡量慢性肝病对受影响患者影响的重要指标，有助于指导改善幸福感的干预措施。然而，肝移植候选者的 HRQOL 与生存之间的关系尚不清楚。我们研究了短格式 36 项健康调查（SF-36）的身体成分综合评分（PCS）和心理成分综合评分（MCS）是否与肝移植候选者的生存有关。我们对肺血管并发症肝病研究中的患者进行了 SF-36 问卷调查（版本 2.0），该研究是一个多中心前瞻性队列研究，在美国 7 个学术中心评估了 2003 年至 2006 年间进行肝移植的患者。使用 Cox 比例风险模型作为主要结果，将死亡作为时间相关协变量进行调整。252 名参与者的平均年龄为 54±10 岁，64%为男性，94%为白人。在 422 人年的随访期间，147 名患者（58%）被列入名单，75 名患者（30%）接受了移植，49 名患者（19%）死亡，3 名患者失访。尽管调整了年龄、性别、终末期肝病模型评分和肝移植，但较低的基线 PCS 评分与死亡率增加相关（趋势 P=0.0001）。MCS 评分与死亡率无关（趋势 P=0.53）。总之，PCS 显著预测了肝移植候选者的生存，针对改善身体状况的干预措施可能有助于改善肝移植候选者的预后。
