Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran.
Iran J Med Sci. 2022 May;47(3):227-235. doi: 10.30476/IJMS.2021.88302.1895.
The health-related quality of life (HRQOL) in the before liver transplantation (LT) stage has not been studied as much as that after the LT stage. We aimed to assess HRQOL and its determinants before the LT stage.
As a cross-sectional study, HRQOL of all adult patients (n=632) referred to the LT center of Shiraz, Iran in 2018-2019 were assessed. Demographic, socioeconomic, medical, and paraclinical data were requested. Physical (PCS) and mental (MCS) aspects of HRQOL were assessed using the SF36 questionnaire. Univariable, multivariable (linear regression), and confirmatory factor analysis were performed utilizing SPSS 20 and Mplus 6.1 software. P<0.05 was considered to be significant.
The mean age of the patients was 47.6±12.3 years, while 414 (65.6%) were men, and the mean, score of the model for end-stage liver disease (MELD) was 18.36±5.58. The mean score of QOL, PCS, and MCS was 50.01±21.73, 46.23±23.23, and 53.78±23.91 (out of 100), respectively. Vitality had the most association with HRQOL, while role limitations had the lowest. The multivariable analysis revealed that unemployment (P<0.001), anemia (P=0.005), weight loss (P=0.005), diabetes mellitus (DM) (P=0.009), low MELD score (P=0.027), and drug use (P=0.03) were the significant determinants of HRQOL, respectively.
The present study showed that HRQOL in the LT candidates was at the intermediate level, while their PCS and MCS are at the low and moderate levels, respectively. Furthermore, physical performance, job status, anemia, weight loss, MELD score, DM, and drug use should be considered as the significant determinants of HRQOL in the LT candidates.
与肝移植（LT）后阶段相比，LT 前阶段的健康相关生活质量（HRQOL）尚未得到充分研究。我们旨在评估 LT 前阶段的 HRQOL 及其决定因素。
作为一项横断面研究，评估了 2018-2019 年伊朗设拉子 LT 中心所有成年患者（n=632）的 HRQOL。要求提供人口统计学、社会经济、医学和临床数据。使用 SF36 问卷评估 HRQOL 的身体（PCS）和精神（MCS）方面。使用 SPSS 20 和 Mplus 6.1 软件进行单变量、多变量（线性回归）和验证性因子分析。P<0.05 被认为具有统计学意义。
患者的平均年龄为 47.6±12.3 岁，其中 414 名（65.6%）为男性，终末期肝病模型（MELD）的平均评分为 18.36±5.58。QOL、PCS 和 MCS 的平均得分分别为 50.01±21.73、46.23±23.23 和 53.78±23.91（满分 100）。活力与 HRQOL 的关联最大，而角色限制与 HRQOL 的关联最小。多变量分析显示，失业（P<0.001）、贫血（P=0.005）、体重减轻（P=0.005）、糖尿病（DM）（P=0.009）、低 MELD 评分（P=0.027）和药物使用（P=0.03）是 HRQOL 的显著决定因素。
本研究表明，LT 候选者的 HRQOL 处于中等水平，而他们的 PCS 和 MCS 分别处于较低和中等水平。此外，身体机能、工作状态、贫血、体重减轻、MELD 评分、DM 和药物使用应被视为 LT 候选者 HRQOL 的重要决定因素。
