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Cited by 283Liver Disease and TransplantationPalliative Care and End-of-Life IssuesHeart Failure Treatment and Management

The DOI matches its Crossref record; 123 of the 123 references it cites were found in a registry or an index.

Symptom prevalence and quality of life of patients with end-stage liver disease: A systematic review and meta-analysis

Open access
Peng, Jen-Kuei, Hepgul, Nilay, Higginson, Irene J, Gao, Wei·2019·Palliative Medicine
DOI 10.1177/0269216318807051PMC PMC6291907
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Abstract

Background: End-stage liver disease is a common cause of morbidity and mortality worldwide, yet little is known about its symptomatology and impact on health-related quality of life. Aim: To describe symptom prevalence and health-related quality of life of patients with end-stage liver disease to improve care. Design: Systematic review. Data sources: We searched eight electronic databases from January 1980 to June 2018 for studies investigating symptom prevalence or health-related quality of life of adult patients with end-stage liver disease. No language restrictions were applied. Meta-analyses were performed where appropriate. Results: We included 80 studies: 35 assessing symptom prevalence, 41 assessing health-related quality of life, and 4 both. The instruments assessing symptoms varied across studies. The most frequently reported symptoms were as follows: pain (prevalence range 30%–79%), breathlessness (20%–88%), muscle cramps (56%–68%), sleep disturbance (insomnia 26%–77%, daytime sleepiness 29.5%–71%), and psychological symptoms (depression 4.5%–64%, anxiety 14%–45%). Erectile dysfunction was prevalent (53%–93%) in men. The health-related quality of life of patients with end-stage liver disease was significantly impaired when compared to healthy controls or patients with chronic liver disease. Compared with compensated cirrhosis, decompensation led to significant worsening of both components of the 36-Item Short Form Survey although to a larger degree for the Physical Component Summary score (decrease from average 6.4 (95% confidence interval: 4.0–8.8); p < 0.001) than for the Mental Component Summary score (4.5 (95% confidence interval: 2.4–6.6); p < 0.001). Conclusion: The symptom prevalence of patients with end-stage liver disease resembled that of patients with other advanced conditions. Given the diversity of symptoms and significantly impaired health-related quality of life, multidisciplinary approach and timely intervention are crucial.

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Figure 1. PRISMA flow diagram.
Figure 1. PRISMA flow diagram.CC BY-NC · PubMed Central
Figure 2. Meta-analysis of the effect of Child–Turcotte–Pugh class (Child B or C vs Child A) or decompensation (decompensated vs compensated liver cirrhosis) on the Physical Component Summary score (Figure 2a) and the Mental Component Summary score (Figure 2b) of the 36-Item Short Form Survey.
Figure 2. Meta-analysis of the effect of Child–Turcotte–Pugh class (Child B or C vs Child A) or decompensation (decompensated vs compensated liver cirrhosis) on the Physical Component Summary score (Figure 2a) and the Mental Component Summary score (Figure 2b) of the 36-Item Short Form Survey.CC BY-NC · PubMed Central

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Citations

Cites

Show all 123 references

Research works printed but not linked: 7

  1. World Health Organization (WHO), 2014, Age-standardized death rates liver cirrhosis (15+ years) per 100000 population, 2012
  2. Kotzeva M (ed.). European social statistics (Eurostat Pocketbooks). 2013 ed. Luxembourg: European Union, 2013, https://annazavaritt.blog.ilsole24ore.com/wp-content/uploads/sites/54/files/eurostat-social-stats-2013-complete-edition.pdf
  3. Abrams GA, 1996, Am J Gastroenterol, 91, 1363
  4. Grassi M, 2001, Minerva Med, 92, 7
  5. 10.1177/152692481002000305 · DOI
  6. Jurado R, 2011, Psicothema, 23, 74
  7. 10.1111/j.1572-0241.2000.03375.x · DOI

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Metadata

Authors
Peng, J.-K., Hepgul, N., Higginson, I. J., & Gao, W.
Affiliations
  • National Taiwan University (TW)
  • King's College London (GB)
Corresponding author
Peng, Jen-Kuei
ORCID
Venue
Palliative Medicine
Publisher
SAGE Publications
Published
2018-10-22
Volume
33
Issue
1
Pages
24-36
ISSN
  • 0269-2163 (ISSN-L)
  • 1477-030X
DOI
10.1177/0269216318807051
PMC
PMC6291907
OpenAlex
W2897616048
Cited by
283
References
123
Citations by year
2026: 30 · 2025: 31 · 2024: 57 · 2023: 47 · 2022: 42 · 2021: 41 · 2020: 24 · 2019: 10 · 2018: 1
FWCI
2.56
Type
journal article
Language
en
Open access
Licence
Locations
  • Palliative Medicine (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, cc-by-nc)
Funders
  • Ministry of Education of Taiwan (educational grant for JKP)
  • National Institute for Health Research (CLAHRC South London at King’s College Hospital NHS)
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Keywords
end-stage liver disease, symptom prevalence, health-related quality of life, pain, dyspnea, muscle cramps, sleep disorders, depression, anxiety, erectile dysfunction, liver cirrhosis, decompensated cirrhosis, chronic liver disease, SF-36
MeSH terms
Adult, Aged, Aged, 80 and over, Female, Humans, Liver Cirrhosis, Male, Middle Aged, Palliative Care, Quality of Life, Severity of Illness Index, Prevalence, End Stage Liver Disease

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