Gastro Unit, Medical Davison, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark.
Department of Gastroenterology and Hepatology, Odense University Hospital, Odense C 5000, Denmark.
World J Gastroenterol. 2018 Apr 21;24(15):1650-1657. doi: 10.3748/wjg.v24.i15.1650.
To develop a scale of domains associated with the health-related quality-of-life (HRQOL) in patients with cirrhosis-related ascites.
We initially undertook literature searches and a qualitative study in order to design a cirrhosis-associated ascites symptom (CAS) scale describing symptoms with a potential detrimental impact on health related quality of life (HRQL) (the higher the score, the worse the symptoms). Discriminatory validity was assessed in a validation cohort including cirrhotic patients with (1) tense/severe; (2) moderate/mild; or (3) no ascites (controls). Patients also completed chronic liver disease questionnaire (CLDQ) and the EuroQoL 5-Dimensions 5-Level (EQ-5D-5L) questionnaire evaluating HRQL. The relation between scale scores was analysed using Spearman correlations.
The final CAS scale included 14 items. The equivalent reliability was high (Chronbach's alpha 0.88). The validation cohort included 103 patients (72% men, mean age 62.4 years). The mean scores for each question in the CAS scale were higher for patients with severe/tense ascites than for mild/moderate ascites and controls. Compared with controls (mean = 9.9 points), the total CAS scale score was higher for severe/tense ascites (mean = 23.8 points) as well as moderate/mild ascites (mean = 18.6 points) ( < 0.001 both groups). We found a strong correlation between the total CAS and CLDQ score (rho = 0.82, < 0.001) and a moderate correlation between the CAS and the EQ-5D-5L score (0.67, < 0.001).
The CAS is a valid tool, which reflects HRQOL in patients with ascites.
开发与肝硬化相关腹水患者健康相关生活质量（HRQOL）相关的领域量表。
我们最初进行了文献检索和定性研究，以设计一种描述可能对健康相关生活质量（HRQL）产生不利影响的症状的肝硬化相关腹水症状（CAS）量表（得分越高，症状越严重）。在一个包括肝硬化患者的验证队列中评估了判别效度，这些患者（1）紧张/严重；（2）中度/轻度；或（3）无腹水（对照组）。患者还完成了慢性肝病问卷（CLDQ）和 EuroQoL 5 维度 5 级（EQ-5D-5L）问卷，评估 HRQL。使用 Spearman 相关分析量表评分之间的关系。
最终的 CAS 量表包括 14 个项目。等效可靠性高（Chronbach's alpha 0.88）。验证队列包括 103 名患者（72%为男性，平均年龄 62.4 岁）。CAS 量表中每个问题的平均得分在严重/紧张性腹水患者中高于轻度/中度腹水患者和对照组。与对照组（平均 9.9 分）相比，严重/紧张性腹水患者的总 CAS 量表评分更高（平均 23.8 分），中度/轻度腹水患者的总 CAS 量表评分也更高（平均 18.6 分）（两组均 <0.001）。我们发现总 CAS 与 CLDQ 评分之间存在很强的相关性（rho = 0.82，<0.001），而 CAS 与 EQ-5D-5L 评分之间存在中度相关性（0.67，<0.001）。
CAS 是一种有效的工具，可反映腹水患者的 HRQOL。
