Patient-Reported Quality of Life and Functional Impairment in Liver Cirrhosis: Clinical Determinants from a Cross-Sectional Study
TL;DR
Health-related quality of life in patients with liver cirrhosis is associated with disease severity as well as with functional and psychosocial aspects of the patient-reported disease experience, and integrating patient-reported outcome measures with conventional clinical assessment may provide a more comprehensive evaluation of disease burden and support individualized multidisciplinary patient management.
Abstract
Background: Liver cirrhosis imposes a substantial clinical, functional, and psychosocial burden, significantly affecting patients’ health-related quality of life (HRQoL). The aim of this study was to evaluate the relationship between disease severity, functional status, and HRQoL in patients with liver cirrhosis. Methods: This cross-sectional observational study included 144 adult patients with liver cirrhosis of diverse etiologies. Clinical, demographic, and laboratory data were collected, while HRQoL was assessed using the Short Form Liver Disease Quality of Life (SF-LDQOL) questionnaire. Disease severity was evaluated according to the Child–Pugh classification. Statistical analysis included descriptive statistics, Spearman correlation, the Kruskal–Wallis test, and Firth penalized multivariable logistic regression. Results: Most patients were classified as Child–Pugh A (75.7%), followed by Child–Pugh B (17.4%) and Child–Pugh C (6.9%). Overall quality of life was predominantly rated as fair or poor. Greater liver-related symptom burden and limitations in daily activities were significantly associated with poorer patient-reported quality-of-life outcomes. Overall quality of life differed significantly across Child–Pugh classes (p < 0.001), with poorer ratings in Child–Pugh B and C than in Child–Pugh A, although impaired quality of life was also observed among patients with compensated cirrhosis. In the forced-entry multivariable clinical model, Child–Pugh B was significantly associated with higher odds of impaired overall quality of life compared with Child–Pugh A (adjusted OR 33.32, 95% CI 1.90–582.94, p = 0.016), whereas age, sex, and etiology were not independently associated with the outcome. Conclusions: Health-related quality of life in patients with liver cirrhosis is associated with disease severity as well as with functional and psychosocial aspects of the patient-reported disease experience. Integrating patient-reported outcome measures with conventional clinical assessment may provide a more comprehensive evaluation of disease burden and support individualized multidisciplinary patient management.