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Mode of allocation and social demographic factors correlate with impaired quality of life after liver transplantation.

Heits N, Meer G, Bernsmeier A, Guenther R, Malchow B, Kuechler T, Becker T, Braun F - Health Qual Life Outcomes (2015)

Bottom Line: There is still disagreement on the effects of social-demographic factors and changes in the allocation system on HRQoL.HCC as a primary disease did not affect HRQoL.Improvement of HRQoL after LTx may require clinical management of pain, psychotherapy and financial support.

View Article: PubMed Central - PubMed

Affiliation: Department of General, Visceral-, Thoracic-, Transplantation- and Pediatric Surgery, University Medical Centre Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller Strasse 3 (Haus 18), 24105, Kiel, Germany. nils.heits@uksh-kiel.de.

ABSTRACT

Background: Health-related Quality of life (HRQoL) is a major goal of clinical management after liver transplantation (LTx). There is still disagreement on the effects of social-demographic factors and changes in the allocation system on HRQoL. The aim of this study was to evaluate the impact of social-demographic factors, mode of organ-allocation, waiting time and hepatocellular carcinoma (HCC) on HRQoL after LTx.

Methods: HRQoL was assessed using the EORTC-QLQ-C30 questionnaire, which was sent to 238 recipients. Investigated parameters included age, sex, distance to transplant center, follow-up at hospital, size of hometown, highest education, marital status, having children, background liver disease, waiting time, mode of allocation, HCC, hospitalization after LTx and diagnosis of malignancy after LTx. All evaluated parameters were entered into multivariate linear regression analysis.

Results: Completed questionnaire were returned by 73% of the recipients. After LTx, the HRQoL-function scales increased over time. Age, marital status, highest education, completed professional training, working status, job position, duration of waiting time to LTx, distance to transplant center, place offollow, HU-statuts, mode of organ allocation and duration of hospitalization were associated with significantly worse function- and significantly lower symptom scales. HCC as a primary disease did not affect HRQoL.

Conclusions: Low HRQoL correlated significantly with MELD-based organ allocation, more than 28-day hospitalization, divorced status, lower education- and non-working status, higher distance to transplant center, follow up at transplant center, HU-status, shorter waiting time to LTx and younger age. Improvement of HRQoL after LTx may require clinical management of pain, psychotherapy and financial support.

No MeSH data available.


Related in: MedlinePlus

Correlation of functioning scores to duration of hospitalization (*p < 0.05)
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Fig5: Correlation of functioning scores to duration of hospitalization (*p < 0.05)

Mentions: Among patients who underwent LTx after more than 180-day waiting period, the HRQoL-score was significantly better for fatigue (p = 0.023). The HRQoL-scores for physical functioning (p = 0.003), role functioning (p = 0.05) and emotional functioning (p = 0.007) were significantly worse in patients with a hospital stay of ≥28 days (Fig. 5). A significantly higher score for physical functioning (p = 0.001) was noted in patients transplanted before the MELD-allocation era. HU-status at time of transplantation was associated with a significantly higher symptom score for financial difficulties. There was no significant difference in HRQoL based on background liver disease. Furthermore, there was no significant difference in the incidence of malignant tumor after LTx. All significant HRQoL-scores are shown in Table 3.Fig. 5


Mode of allocation and social demographic factors correlate with impaired quality of life after liver transplantation.

Heits N, Meer G, Bernsmeier A, Guenther R, Malchow B, Kuechler T, Becker T, Braun F - Health Qual Life Outcomes (2015)

Correlation of functioning scores to duration of hospitalization (*p < 0.05)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4588670&req=5

Fig5: Correlation of functioning scores to duration of hospitalization (*p < 0.05)
Mentions: Among patients who underwent LTx after more than 180-day waiting period, the HRQoL-score was significantly better for fatigue (p = 0.023). The HRQoL-scores for physical functioning (p = 0.003), role functioning (p = 0.05) and emotional functioning (p = 0.007) were significantly worse in patients with a hospital stay of ≥28 days (Fig. 5). A significantly higher score for physical functioning (p = 0.001) was noted in patients transplanted before the MELD-allocation era. HU-status at time of transplantation was associated with a significantly higher symptom score for financial difficulties. There was no significant difference in HRQoL based on background liver disease. Furthermore, there was no significant difference in the incidence of malignant tumor after LTx. All significant HRQoL-scores are shown in Table 3.Fig. 5

Bottom Line: There is still disagreement on the effects of social-demographic factors and changes in the allocation system on HRQoL.HCC as a primary disease did not affect HRQoL.Improvement of HRQoL after LTx may require clinical management of pain, psychotherapy and financial support.

View Article: PubMed Central - PubMed

Affiliation: Department of General, Visceral-, Thoracic-, Transplantation- and Pediatric Surgery, University Medical Centre Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller Strasse 3 (Haus 18), 24105, Kiel, Germany. nils.heits@uksh-kiel.de.

ABSTRACT

Background: Health-related Quality of life (HRQoL) is a major goal of clinical management after liver transplantation (LTx). There is still disagreement on the effects of social-demographic factors and changes in the allocation system on HRQoL. The aim of this study was to evaluate the impact of social-demographic factors, mode of organ-allocation, waiting time and hepatocellular carcinoma (HCC) on HRQoL after LTx.

Methods: HRQoL was assessed using the EORTC-QLQ-C30 questionnaire, which was sent to 238 recipients. Investigated parameters included age, sex, distance to transplant center, follow-up at hospital, size of hometown, highest education, marital status, having children, background liver disease, waiting time, mode of allocation, HCC, hospitalization after LTx and diagnosis of malignancy after LTx. All evaluated parameters were entered into multivariate linear regression analysis.

Results: Completed questionnaire were returned by 73% of the recipients. After LTx, the HRQoL-function scales increased over time. Age, marital status, highest education, completed professional training, working status, job position, duration of waiting time to LTx, distance to transplant center, place offollow, HU-statuts, mode of organ allocation and duration of hospitalization were associated with significantly worse function- and significantly lower symptom scales. HCC as a primary disease did not affect HRQoL.

Conclusions: Low HRQoL correlated significantly with MELD-based organ allocation, more than 28-day hospitalization, divorced status, lower education- and non-working status, higher distance to transplant center, follow up at transplant center, HU-status, shorter waiting time to LTx and younger age. Improvement of HRQoL after LTx may require clinical management of pain, psychotherapy and financial support.

No MeSH data available.


Related in: MedlinePlus