Health-related quality of life in chronic liver disease: The impact of type and severity of disease

OBJECTIVE: The type and severity of chronic liver disease may have differen t effects on health-related quality of life (HRQL). The aim of our study wa s to determine whether HRQL in patients with chronic liver disease differs by type and severity of disease and to identify which clinical and physiolo gical factors affect this impairment. METHODS: In this study, HRQL was measured with a generic (Short Form 36) an d a liver disease-specific (Chronic Liver Disease Questionnaire) questionna ire. Clinical, demographic, and laboratory data were collected at office vi sits. Patient's HRQL scores were compared with the published norms and to t he chronically ill populations. A total of 353 patients (mean age 50 yr, 51 % men) with chronic liver disease, either viral disease (hepatitis B and C) , cholestatic disease (primary biliary cirrhosis or primary sclerosing chol angitis), or hepatocellular disease were enrolled in the study. RESULTS: In general, HRQL in patients with chronic liver disease was lower than the normal population and was similar to that of patients with chronic obstructive pulmonary disease or congestive heart failure. In cirrhotic pa tients, some dimensions of HRQL were less impaired in patients with cholest atic disease than in those with hepatocellular diseases. More severe diseas e (higher Child's class) was associated with a lower Chronic Liver Disease Questionnaire score and the Short Form 36's physical component summary scor es. Older age had a weak negative association with the physical aspects of HRQL. CONCLUSIONS: We conclude that chronic liver disease substantially reduces H RQL, and this impact does not differ markedly by type of disease. Older age and measures of disease severity were associated with poorer HRQL. (C) 200 1 by Am. Cell. of Gastroenterology.