ASSESSMENT OF HEALTH – RELATED QUALITY OF LIFE IN PATIENTS WITH CHRONIC LIVER DISEASE IN A TERTIARY HOSPITAL: A CROSS – SECTIONAL PROSPECTIVE STUDY

M.A.B. Buenaventura, MD; M.A.V. Chu, MD;L.B. Gatchalian, MD; M.Talingdan-Te, MD; S.D. Preza-Carmona, MD
Section of Gastroenterology, Department of Internal Medicine , East Avenue Medical Center, East Avenue, Diliman, Quezon City, Philippines

Significance: Chronic liver disease is known to cause significant morbidity and mortality, typically due to a number of complications that include ascites, hepatic encephalopathy, variceal hemorrhage and hepatorenal syndrome. CLD negatively impacts health-related quality of life. The aim of this study is to investigate the factors affecting health-related quality of life (HRQOL) in Filipino patients with chronic liver disease. Understanding the correlation between CLD and HRQOL may have major public health implications and has the potential to lead in the development of future therapies.

Methodology: The study design is a cross-sectional analysis composed of all chronic liver disease patients. Stratified random sampling was used to collect a total of 90 subjects with Chronic Liver Disease in a tertiary hospital. Clinical profile was measured, as well as measures of health related quality of life using a validated HRQOL tool (Short Form 36). Specific outcomes such as physical functioning, social functioning, role limitations due to physical functioning, bodily pain, general mental health, role limitations due to emotional functioning, vitality and general health perception are the eight domains covered by the HRQOL tool. Descriptive statistics was used to summarize the demographic and clinical characteristics of the patients. Normality testing of the continuous data was also carried out. Categorical data were presented as frequency and percentages, whereas continuous data were reported as median and interquartile range (IQR). The bivariate association between different domains of health-related quality of life (HRQOL) and socio-demographic and clinical parameters were analyzed using Mann-Whitney U test and Kruskal-Wallis H test.

Results: There were 90 patients with Chronic Liver Disease included in the study. 40% of these patients have chronic hepatitis B as the cause of CLD. Majority of the population is classified as Child Pugh C which accounted for 41 patients (45.6%). Ascites is present in 70 of these patients, of which 57 (63%) has grade 2 ascites.For the health-related quality of life (HRQOL) score, Role of Limitation due to physical health (median=12.5) was the lowest among 8 domains. On the contrary, Social functioning had the highest score (median=62.5). A Child Pugh score of A (5-6) and MELD scores less than 9 had higher median scores and were both significantly associated with all domains. Presence of ascites is significantly associated with physical functioning and Role of Limitation due to physical health , yielding lower scores. Lastly, Patients who had normal UGIE tend to have higher HRQOL scores in all domains except social functioning.

Conclusion: In this study, advanced chronic liver disease is significantly associated with impaired HRQOL. Clinical factors such as severity of chronic liver disease and presence of ascites worsen HRQOL in this population.

Keywords: Chronic Liver Disease, Liver, Health Related Quality of Life, Quality of Life

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