Cholestatic liver diseases and health-related quality of life

• Published in: The American journal of gastroenterology Vol. 95; no. 2; pp. 497 - 502
• Main Authors: Younossi, Zobair M, Kiwi, Michelle L, Boparai, Navdeep, Price, Lori Lyn, Guyatt, Gordon
• Format: Journal Article
• Language: English
• Published: Oxford . 01-02-2000; Blackwell Publishing; Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
• Subjects: Analysis of Variance; Bilirubin - blood; Biological and medical sciences; Cholangitis, Sclerosing - classification; Cholangitis, Sclerosing - physiopathology; Cholestasis - classification; Cholestasis - physiopathology; Chronic Disease; Cross-Sectional Studies; Diabetes Mellitus - physiopathology; Female; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Health Status; Heart Failure - physiopathology; Humans; Liver Cirrhosis - classification; Liver Cirrhosis - physiopathology; Liver Cirrhosis, Biliary - classification; Liver Cirrhosis, Biliary - physiopathology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Lung Diseases, Obstructive - physiopathology; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Pruritus - physiopathology; Quality of Life; Regression Analysis; Severity of Illness Index; Handicap; Human; Immunopathology; Hepatic disease; Autoimmune disease; Biliary cirrhosis; Biliary tract disease; Epidemiology; Quality of life; Primitive; Cholostasis; Digestive diseases; Evolution; Sclerosing cholangitis
• ISSN: 0002-9270; 1572-0241
• DOI: 10.1111/j.1572-0241.2000.01774.x

Symptoms associated with primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) negatively affect health-related quality of life (HRQL). The aim of this study was to measure HRQL in patients with chronic cholestatic liver diseases and to determine factors associated with more severe impairment. We conducted a cross-sectional study in which we documented patients' demographic and clinical characteristics, and measured their HRQL using the Short Form-36 and Chronic Liver Disease Questionnaire. We assessed the association of HRQL impairment with disease severity (Child's-Pugh class and Mayo PBC Risk Score) and compared patients' HRQL with those of a healthy population, and patients with congestive heart failure, chronic obstructive pulmonary disease, and diabetes. One hundred and four patients with PBC and PSC participated, of whom 73% were women, with an average age of 55 ± 12 yr. Of these patients, 61% had cirrhosis (37% Child's A, 23% Child's B, and 2% Child's C). Patients with cholestatic liver disease showed more HRQL impairment than the healthy population and were similar to patients with other chronic conditions. Additionally, patients who experienced severe itching showed profound HRQL impairment. In patients with PBC, Physical Component Summary (PCS) scores of the SF-36 and Chronic Liver Disease Questionnaire (CLDQ) scores fell from noncirrhotic to Child's A to Child's B/C and with worsening Mayo PBC Risk Scores. No other clinicodemographic data were associated with patients' well-being. Patients with cholestatic liver disease (PBC and PSC) showed substantial impairment of HRQL, which is further affected by worsening disease severity. Disease-specific measures were better able to discriminate patients with varying severities.