Cholestatic liver diseases and health-related quality of life

OBJECTIVE: Symptoms associated with primary biliary cirrhosis (PBC) and pri mary 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. METHODS: We conducted a cross-sectional study in which we documented patien ts' 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 a nd Mayo PBC Risk Score) and compared patients' HRQL with those of a healthy population, and patients with congestive heart failure, chronic obstructiv e pulmonary disease, and diabetes. RESULTS: One hundred and four patients with PBC and PSC participated, of wh om 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). Patient s with cholestatic liver disease showed more HRQL impairment than the healt hy population and were similar to patients with other chronic conditions. A dditionally, patients who experienced severe itching showed profound HRQL i mpairment. 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 S cores. No other clinicodemographic data were associated with patients' well -being. CONCLUSIONS: Patients with cholestatic liver disease (PBC and PSC) showed s ubstantial impairment of HRQL, which is further affected by worsening disea se severity. Disease-specific measures were better able to discriminate pat ients with varying severities. (C) 2000 by Am. Cell. of Gastroenterology.