RELATIONSHIP BETWEEN CLINICAL SEVERITY AND HEALTH RELATED QUALITY OF LIFE IN CHRONIC LIVER DISEASES
Author(s)
Scalone L1, Cortesi PA1, Ciampichini R2, Okolicsanyi S3, Rota M3, Ciaccio A3, Ideo G4, Colledan M5, Belli LS6, Cesana G1, Mantovani LG7, Strazzabosco M31University of Milano - Bicocca, Monza, Italy, 2Charta Foundation, Milan, Italy, 3University of Milano - Bicocca, Monza (MB), Italy, 4Fondazione FADE, Milano, Italy, 5Ospedali Riuniti, Bergamo, Italy, 6Niguarda Hospital, Milan, Italy, 7Federico II University of Naples, Naples , Italy
OBJECTIVES: To assess the relationship between the type of chronic liver diseases (CLDs), clinical severity and patients’ HRQoL. METHODS: A naturalistic, multicentre study has been conducting to identify and test quality of care indicators. Adult CLDs patients (age>18 years) have been enrolling at gastroenterology unit of 3 Italian hospitals. We are collecting socio-demographic, clinical and HRQoL data with the EQ-5D-3L. Patients are sub-grouped according to CLD type and to clinical severity using the modified Child-Turcotte-Pugh score: with this instrument, patients are classified as non-cirrhotic, early cirrhotic (class A), advanced cirrhotic (classes B and C). We conducted Kruskall-Wallis tests to assess relationship between EQ-5D-VAS score and disease type or severity score. RESULTS: Results are based on data from 2,221 patients (67% male, median age=62 years), classified into the following subgroups: HCV or HBV chronic hepatitis (36.0%), compensated cirrhosis (CC, 23.5%), hepatocellular carcinoma (HCC, 19.8%), decompensated cirrhosis (DC, 13.5%), patients in evaluation or listed for liver transplant (LT, 7.2%). Non-cirrhotic patients (HCV or HBV chronic hepatitis) had significantly (p<0.001) higher median VAS (80) than patients with any other CLD types (70). In contrast, patients listed for LT had the lowest (p<0.05) median VAS (65) and the highest proportion of patients (58.1%) in Child class B-C. DC patients had a median VAS not significantly different from that of HCC or CC patients (70 versus 70 and 73, respectively). On the other hand, DC patients in child class A showed a significantly (p<0.05) higher median VAS (72.5) than HCC and CC patients in class B-C, who had a median VAS of 70 and 60, respectively. CONCLUSIONS: HRQoL of CLDs patients is significantly related with the Child-Turcotte-Pugh severity score. These results could be useful to understand the impact of the disease severity on patients’ HRQoL and guide some decisions in clinical care.
Conference/Value in Health Info
2012-11, ISPOR Europe 2012, Berlin, Germany
Value in Health, Vol. 15, No. 7 (November 2012)
Code
PGI36
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
Gastrointestinal Disorders