Departments of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
Departments of Surgery, University of California at Los Angeles, Los Angeles, CA, USA.
Dig Dis Sci. 2021 Oct;66(10):3343-3351. doi: 10.1007/s10620-020-06687-4. Epub 2020 Nov 2.
Frailty is common and is associated with increased mortality, lower quality of life, and higher readmission rates in cirrhotic patients. Not only are these outcomes important, but further understanding the impact of frailty on a caregiver's life is crucial to better comprehend caregiver burden in cirrhotic patients and develop strategies to improve care for patients and their caregivers.
A single-center, prospective study was conducted of cirrhotic patients and their caregivers between 4/1/2019 and 11/1/2019. Frailty testing combined aspects from the Fried Frailty Instrument, Short Physical Performance Battery, and activities of daily living. Caregivers completed questionnaires to evaluate caregiver burden using the Zarit Burden Interview (ZBI-12), and perceived social support, using the Interpersonal Support Evaluation List.
In total, 94 cirrhotic patients were included, 50% males with a median age of 63.1 years. The most common etiology of cirrhosis was nonalcoholic steatohepatitis. Frailty was prevalent (45.1%). In total, 12.8% of caregivers reported a high burden based on ZBI-12. There was no association between frailty and caregiver burden, hospitalization rates, or death. However, frailty was associated with a higher number of outpatient GI visits (p = 0.002). Lower perceived social support among caregivers was associated with a higher caregiver burden (p < 0.0001).
Frailty is prevalent in cirrhotic patients but is not associated with higher rates of caregiver burden. Low perceived social support among caregivers, however, was associated with higher caregiver burden. It is important to recognize the impact of caregiver burden on caregivers of cirrhotic patients and ensure caregivers have the appropriate support to mitigate burden.
衰弱在肝硬化患者中很常见，与死亡率增加、生活质量降低和再入院率升高有关。这些结果不仅很重要，而且进一步了解衰弱对照顾者生活的影响对于更好地理解肝硬化患者照顾者的负担并制定改善患者及其照顾者护理的策略至关重要。
对 2019 年 4 月 1 日至 11 月 1 日期间的肝硬化患者及其照顾者进行了一项单中心前瞻性研究。衰弱测试结合了 Fried 衰弱量表、简短体能测试和日常生活活动的方面。照顾者使用 Zarit 负担访谈 (ZBI-12) 评估照顾者负担，并使用人际支持评估清单 (Interpersonal Support Evaluation List) 评估感知社会支持。
共纳入 94 例肝硬化患者，其中 50%为男性，中位年龄为 63.1 岁。肝硬化最常见的病因是非酒精性脂肪性肝炎。衰弱很常见（45.1%）。根据 ZBI-12，共有 12.8%的照顾者报告负担较重。衰弱与照顾者负担、住院率或死亡率之间无关联。然而，衰弱与更多的门诊胃肠就诊次数有关（p=0.002）。照顾者感知社会支持较低与较高的照顾者负担相关（p<0.0001）。
肝硬化患者中衰弱很常见，但与较高的照顾者负担无关。然而，照顾者感知社会支持较低与较高的照顾者负担相关。重要的是要认识到照顾者负担对肝硬化患者照顾者的影响，并确保照顾者得到适当的支持以减轻负担。
