Factors Affecting Health-Related Quality of Life in Patients After a Liver Transplant: A Cross-Sectional, Single-Centre, Large-Cohort Study

影响肝移植术后患者健康相关生活质量的因素:一项横断面、单中心、大型队列研究

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Abstract

Background/Objectives: Over the past decades there has been a remarkable improvement in the clinical outcomes and prognoses after orthotopic liver transplantation (OLTx). Health-related quality of life (HRQoL) has emerged as an important concept for assessing the success of this procedure. We aimed to assess critical aspects of HRQoL in patients transplanted at our centre. Methods: We recruited 420 OLTx recipients and divided them into three groups based on the time since surgery. Two hundred and seventy-five controls were matched for age and gender. The Medical Outcomes Study Short Form (SF-36), International Physical Activity Questionnaire, Patient Health Questionnaire-9 (PHQ-9), and the Modified Fatigue Impact Scale (MFIS) were used to assess HRQoL, physical activity levels, depression, and chronic fatigue, respectively. Results: Compared to controls, OLTx patients exhibited grossly comparable HRQoL except for the physical component score (PCS) and mental domains of the SF-36. There was a significant correlation between the impairment of the PCS and depression and between the PCS and chronic fatigue. Physically active patients scored significantly lower in the MFIS, and there was a strong correlation between depression and chronic fatigue. Females exhibited more pronounced symptoms of depression and chronic fatigue than males but comparable physical activity levels and general QoL. Unemployed patients had significantly higher scores in the PHQ-9/MFIS. Conclusions: The general HRQoL of OLTx patients was similar to controls. However, patients were less physically active and more frequently unemployed. As depression and chronic fatigue occurred more often in females, particular attention should be paid to their psychiatric assessment.

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