Pradhan Ravi R, Kafle Bhandari Brindeswari, Pathak Rahul, Poudyal Sagar, Anees Shahbaz, Sharma Sashi, Khadga Prem
Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, NPL.
Gastroenterology, Tribhuvan University Institute of Medicine, Kathmandu, NPL.
Cureus. 2020 Sep 30;12(9):e10727. doi: 10.7759/cureus.10727.
Aim The aim of this study was to investigate the factors affecting health-related quality of life (HRQOL) in Nepalese patients with chronic liver disease (CLD). Methods In this study, HRQOL was measured with validated Nepali versions of the short-form 36 (SF-36) survey. Socioeconomic factors, etiology, laboratory parameters, disease severity, and self-rated health perceptions on HRQOL were recorded for analysis. Results Sixty CLD patients were enrolled in the study. The following HRQOL scores were obtained: physical functioning (PF) (34.4 ±26.7), role limitation due to physical health (RLPH) (7.5 ±17.8), role limitation due to emotional problems (RLEP) (27.7 ±38.2), energy or fatigue (E/F) (38.5 ±21.5), emotional well-being (EWB) (57.7 ±22.8), social functioning (SF) (55.2 ±23.5), pain (44.8 ±30.3), and general health (GH) (38.2 ±17). Employed status and higher annual family income had a positive impact on HRQOL. Ascites and abnormal upper gastrointestinal endoscopic findings were associated with poor health status perceptions. More severe disease (higher Child-Pugh class) was associated with lower HRQOL scores. A significant negative correlation between the model for end-stage liver disease (MELD) score and HRQOL domains was observed (p: <0.05). Age, gender, religion, education, and duration of the diagnosis of CLD had no effect on HRQOL of CLD patients. Conclusion HRQOL in patients with CLD was lower than that in the general population. Unemployed status, low annual family income, ascites, abnormal upper gastrointestinal endoscopic findings, and higher Child-Pugh class and MELD scores were important factors that adversely affected HRQOL.
目的 本研究旨在调查影响尼泊尔慢性肝病(CLD)患者健康相关生活质量(HRQOL)的因素。方法 在本研究中,使用经过验证的尼泊尔语版简短健康调查问卷(SF-36)来测量HRQOL。记录社会经济因素、病因、实验室参数、疾病严重程度以及对HRQOL的自我健康认知情况进行分析。结果 60例CLD患者纳入研究。获得以下HRQOL评分:生理功能(PF)(34.4±26.7)、因身体健康导致的角色受限(RLPH)(7.5±17.8)、因情感问题导致的角色受限(RLEP)(27.7±38.2)、精力或疲劳(E/F)(38.5±21.5)、情感健康(EWB)(57.7±22.8)、社会功能(SF)(55.2±23.5)、疼痛(44.8±30.3)和总体健康(GH)(38.2±17)。就业状况和较高的家庭年收入对HRQOL有积极影响。腹水和上消化道内镜检查异常结果与健康状况认知较差有关。更严重的疾病(较高的Child-Pugh分级)与较低的HRQOL评分有关。观察到终末期肝病模型(MELD)评分与HRQOL领域之间存在显著负相关(p:<0.05)。年龄、性别、宗教、教育程度和CLD诊断时长对CLD患者的HRQOL没有影响。结论 CLD患者的HRQOL低于一般人群。失业状况、低家庭年收入、腹水、上消化道内镜检查异常结果以及较高的Child-Pugh分级和MELD评分是对HRQOL产生不利影响的重要因素。