Factores clínicos de percepción baja de la calidad de vida relacionada con la salud en pacientes con cirrosis compensada
Palabras clave:
Calidad de vida, cirrosis, CLDQResumen
Introducción: las enfermedades crónicas del hígado y en particular la cirrosis, repercuten de manera desfavorable sobre la calidad de vida relacionada con la salud de estos enfermos. Objetivos: determinar la frecuencia con que ciertos factores propios de la cirrosis compensada conducen a una baja percepción de la calidad de vida relacionada con la salud. Métodos: se realizó estudio descriptivo, prospectivo, de corte transversal entre el 1º de julio de 2017 a 31 de diciembre de 2018 con pacientes con cirrosis compensada y que no tuvieran otras de enfermedades crónicas debilitantes. Se clasificó la percepción como alta o baja, según puntaje del Chronic Liver Disease Questionnaire y se compararon variables clínicas y humorales entre los dos grupos. Resultados: se estudiaron 72 pacientes; 43 masculinos (59.7 %) y 29 femeninas (40.3 %), con media para la edad de 61.4±10.27 años. La media global de calidad de vida fue de 4.8±1,28 puntos y fue baja para 29 pacientes (40.3 %). Se identificó al sexo femenino (p=0.001), infección por el virus de hepatitis C (p=0.32) y el aumento de ALAT (p=0.04), ASAT (p=0.02) y fosfatasa alcalina (p=0.04) como las variables más frecuentes en los pacientes con baja calidad de vida. Conclusiones: existen diferencias en ciertas determinantes clínicas y humorales influyen en la percepción de la calidad de vida, lo que ratifica el valor tanto de los aspectos biológicos como de los psicológicos, aún en la fase compensada de la enfermedad.
Descargas
Citas
Younossi ZM, Guyatt G. Quality-of-life assessments and chronic liver disease. The American journal of gastroenterology [Internet]. 1998 Jul; 93(7):[1037-41 pp.]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9672326.
Younossi ZM. Chronic liver disease and health-related quality of life. Gastroenterology [Internet]. 2001 Jan; 120(1):[305-7 pp.]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11208742.
Soriano G, Román E. El reto de la calidad de vida en pacientes con cirrosis. Gastroenterol Hepatol [Internet]. 2012; 35 (Espec Congr 1):[52-9 pp.]. Available from: https://www.elsevier.es/es-revista-gastroenterologia-hepatologia-14-articulo-el-reto-calidad-vida-pacientes-X0210570512955908.
Borges González S, Infante Velázquez M, Castellanos Fernández M, LM. LM, González Suero S, Ruenes Domech C, et al. Adaptación de la versión al español del Chronic Liver Disease. Arch cuba gastroenterol [Internet]. 2020; 1(3). Available from: www.revgastro.sld.cu/index.php/gast/article/view/52.
Rabiee A, Ximenes RO, Nikayin S, Hickner A, Juthani P, Rosen RH, et al. Factors associated with health-related quality of life in patients with cirrhosis: a systematic review. Liver Int [Internet]. 2021 Jan; 41(1):[6-15 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32998172.
Wachtel MS, Zhang Y, Kaye KE, Chiriva-Internati M, Frezza EE. Increased age, male gender, and cirrhosis, but not steatosis or a positive viral serology, negatively impact the life expectancy of patients who undergo liver biopsy. Dig Dis Sci [Internet]. 2007 Sep; 52(9):[2276-81 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17406827.
Riedel AN, Kimer N, Jensen AH, Dahl EK, Israelsen M, Aamann L, et al. Development and predictive validity of the cirrhosis-associated ascites symptom scale: A cohort study of 103 patients. World J Gastroenterol [Internet]. 2018 Apr 21 PMC5910548]; 24(15):[1650-7 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29686472.
Hayward KL, Valery PC, Martin JH, Karmakar A, Patel PJ, Horsfall LU, et al. Medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis. World J Gastroenterol [Internet]. 2017 PMC5677197]; 23(40):[7321-31 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29142479.
Sclair SN, Carrasquillo O, Czul F, Trivella JP, Li H, Jeffers L, et al. Quality of Care Provided by Hepatologists to Patients with Cirrhosis at Three Parallel Health Systems. Dig Dis Sci [Internet]. 2016 Oct; 61(10):[2857-67 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27289585.
Takahashi A, Moriya K, Ohira H, Arinaga-Hino T, Zeniya M, Torimura T, et al. Health-related quality of life in patients with autoimmune hepatitis: A questionnaire survey. PLoS One [Internet]. 2018; 13(10):[e0204772 p.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30286131.
Takahashi A, Abe M, Yasunaka T, Arinaga-Hino T, Abe K, Takaki A, et al. Quality of life among patients with autoimmune hepatitis in remission: A comparative study. Medicine (Baltimore) [Internet]. 2020 Oct 23 PMC7581115]; 99(43):[e22764 p.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33120784.
Yamamura S, Nakano D, Hashida R, Tsutsumi T, Kawaguchi T, Okada M, et al. Patient-reported outcomes in patients with non-alcoholic fatty liver disease: A narrative review of Chronic Liver Disease Questionnaire-non-alcoholic fatty liver disease/non-alcoholic steatohepatitis. J Gastroenterol Hepatol [Internet]. 2020 Jul 6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32627871.
Zhang H, Ren R, Liu J, Mao Y, Pan G, Men K, et al. Health-Related Quality of Life among Patients with Hepatitis C Virus Infection: A Cross-Sectional Study in Jianping County of Liaoning Province, China. Gastroenterol Res Pract [Internet]. 2020 PMC7199638]; 2020:[6716103 p.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32411200.
Paparrigopoulos T, Tzavellas E, Karaiskos D, Liappas I. Should impaired liver function be held responsible for cognitive impairment and poor health-related quality of life in alcoholic cirrhosis? Hepatology [Internet]. 2007 Sep; 46(3):[950; author reply 1 p.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17879357.
McSweeney L, Breckons M, Fattakhova G, Oluboyede Y, Vale L, Ternent L, et al. Health-related quality of life and patient-reported outcome measures in NASH-related cirrhosis. JHEP Rep [Internet]. 2020 Jun; 2(3):[100099 p.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32435754.
Barboza KC, Salinas LM, Sahebjam F, Jesudian AB, Weisberg IL, Sigal SH. Impact of depressive symptoms and hepatic encephalopathy on health-related quality of life in cirrhotic hepatitis C patients. Metab Brain Dis [Internet]. 2016; 31(4):[869-80 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27032930.
Hsu PC, Krajden M, Yoshida EM, Anderson FH, Tomlinson GA, Krahn MD. Does cirrhosis affect quality of life in hepatitis C virus-infected patients? Liver Int [Internet]. 2009 Mar; 29(3):[449-58 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19267865.
Gentile I, Scotto R, Coppola C, Staiano L, Amoruso DC, De Simone T, et al. Treatment with direct-acting antivirals improves the clinical outcome in patients with HCV-related decompensated cirrhosis: results from an Italian real-life cohort (Liver Network Activity-LINA cohort). Hepatol Int [Internet]. 2019 Jan; 13(1):[66-74 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30523552.
Younossi ZM, Stepanova M, Balistreri W, Schwarz K, Murray KF, Rosenthal P, et al. Health-related Quality of Life in Adolescent Patients With Hepatitis C Genotype 1 Treated With Sofosbuvir and Ledipasvir. J Pediatr Gastroenterol Nutr [Internet]. 2018 Jan; 66(1):[112-6 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28957984.
Younossi ZM, Stepanova M, Henry L, Han KH, Ahn SH, Lim YS, et al. Sofosbuvir and ledipasvir are associated with high sustained virologic response and improvement of health-related quality of life in East Asian patients with hepatitis C virus infection. J Viral Hepat [Internet]. 2018 Dec; 25(12):[1429-37 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29974665.
Youssef NF, Shepherd A, Evans JM. Factors associated with health-related quality of life among patients with liver cirrhosis in Egypt. J Egypt Public Health Assoc [Internet]. 2015 Mar; 90(1):[14-9 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25853540.
Thiele M, Askgaard G, Timm HB, Hamberg O, Gluud LL. Predictors of health-related quality of life in outpatients with cirrhosis: results from a prospective cohort. Hepat Res Treat [Internet]. 2013 PMC3896069]; 2013:[479639 p.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24490061.
D'Amico G, Morabito A, D'Amico M, Pasta L, Malizia G, Rebora P, et al. New concepts on the clinical course and stratification of compensated and decompensated cirrhosis. Hepatol Int [Internet]. 2018 Feb; 12(Suppl 1):[34-43 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28681347.
Lapointe-Shaw L, Georgie F, Carlone D, Cerocchi O, Chung H, Dewit Y, et al. Identifying cirrhosis, decompensated cirrhosis and hepatocellular carcinoma in health administrative data: A validation study. PLoS One [Internet]. 2018; 13(8):[e0201120 p.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30133446.
Dirchwolf M, Podhorzer A, Marino M, Shulman C, Cartier M, Zunino M, et al. Immune dysfunction in cirrhosis: Distinct cytokines phenotypes according to cirrhosis severity. Cytokine [Internet]. 2016 Jan; 77:[14-25 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26517154.
Rogal SS, Bielefeldt K, Wasan AD, Lotrich FE, Zickmund S, Szigethy E, et al. Inflammation, psychiatric symptoms, and opioid use are associated with pain and disability in patients with cirrhosis. Clin Gastroenterol Hepatol [Internet]. 2015 PMC4846465]; 13(5):[1009-16 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25460019.
Wunsch E, Koziarska D, Milkiewicz M, Naprawa G, Nowacki P, Hartleb M, et al. In patients with liver cirrhosis, proinflammatory interleukins correlate with health-related quality of life irrespective of minimal hepatic encephalopathy. Eur J Gastroenterol Hepatol [Internet]. 2013 Dec; 25(12):[1402-7 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24025977.
Raszeja-Wyszomirska J, Wunsch E, Krawczyk M, Rigopoulou EI, Kostrzewa K, Norman GL, et al. Assessment of health related quality of life in polish patients with primary biliary cirrhosis. Clin Res Hepatol Gastroenterol [Internet]. 2016 Sep; 40(4):[471-9 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26621536.
Hegade VS, Bolier R, Oude Elferink RP, Beuers U, Kendrick S, Jones DE. A systematic approach to the management of cholestatic pruritus in primary biliary cirrhosis. Frontline Gastroenterol [Internet]. 2016 Jul PMC5369477]; 7(3):[158-66 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28839853.
Ahluwalia V, Wade JB, Thacker L, Kraft KA, Sterling RK, Stravitz RT, et al. Differential impact of hyponatremia and hepatic encephalopathy on health-related quality of life and brain metabolite abnormalities in cirrhosis. J Hepatol [Internet]. 2013 Sep PMC3748234]; 59(3):[467-73 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23665182.
Cardenas A, Gines P, Marotta P, Czerwiec F, Oyuang J, Guevara M, et al. Tolvaptan, an oral vasopressin antagonist, in the treatment of hyponatremia in cirrhosis. J Hepatol [Internet]. 2012 Mar; 56(3):[571-8 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22027579.
Sinha VK, Ko B. Hyponatremia in Cirrhosis--Pathogenesis, Treatment, and Prognostic Significance. Adv Chronic Kidney Dis [Internet]. 2015 Sep; 22(5):[361-7 pp.]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26311597.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2024 Archivos Cubanos de Gastroenterolog?a
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
La revista reconoce a las personas que firman como autores siempre y cuando estos cumplan con los criterios establecidos universalmente para los autores de los art?culos cient?ficos. Regularmente se solicitar? a los autores de art?culos originales, env?en la declaraci?n de autor?a firmada por cada uno de ellos y donde se explique su rol dentro de la investigaci?n. El comit? editorial se reserva el derecho de aceptar determinados autores en relaci?n con el rol declarado y la envergadura de la investigaci?n.
Esta revista protege los Derechos de autor desde el mismo momento en que se realiza el env?o. Sin embargo, cede parte de los derechos patrimoniales de autor al exhibir una licencia Creative Commons 4.0 (cc-by-nc), que permite el uso de la obra para compartir (copiar y redistribuir el material en cualquier medio o formato) y adaptar (remezclar, transformar y construir a partir del material) siempre y cuando se haga menci?n exclusiva a la publicaci?n en la revista como fuente primaria. ?Sin embargo, no podr? comercializar con ella.
?
