Abstract
Patients with liver cirrhosis experience a significantly reduced health-related quality of life (HRQoL) due to a multifaceted interaction of physiological, psychological, and social factors. Identifying these key determinants is crucial for enhancing care strategies and treatment outcomes. This study systematically explored the factors influencing both negative and positive aspects of HRQoL in patients with liver cirrhosis. A comprehensive literature search was performed across PubMed, Scopus, Embase, and Google Scholar, focusing on original research published since January 1, 2021. Studies involving sarcopenia in cirrhosis and its impact on HRQoL, including various subgroups and influencing factors, were included to ensure a wide-ranging analysis. The review identified multiple significant risk factors associated with poor HRQoL in cirrhotic patients. These included advanced age, female gender, lower socioeconomic status, low body mass index, and the presence of comorbid conditions such as anxiety and depression. Additionally, complications like ascites, hepatic encephalopathy, abnormal endoscopic findings, higher disease severity scores, sarcopenia, disturbed sleep, impaired sexual function, muscle cramps, and elevated levels of bilirubin, prothrombin time, and albumin-bilirubin ratio were linked to diminished HRQoL. On the other hand, interventions such as increased physical activity, liver transplantation, stem cell therapy, mindfulness practices, and the use of probiotics, rifaximin, and lactulose showed positive effects on HRQoL. These insights underscore the importance of adopting a comprehensive management approach for liver cirrhosis that addresses not only physical health but also psychological and social well-being. Future research should aim at developing targeted interventions to reduce the burden of these risk factors and promote overall quality of life in this patient population.