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Symptom Classes in Decompensated Liver Disease.

Lissi Hansen1, Michael F Chang2, Shirin Hiatt1

  • 1School of Nursing, Oregon Health and Science University, Portland, Oregon.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|November 23, 2021
PubMed
Summary
This summary is machine-generated.

Patient symptom severity in end-stage liver disease is not tied to disease state. Three symptom classes (mild, moderate, severe) were identified, impacting quality of life and coping strategies.

Keywords:
Decompensated Liver DiseaseDepressionQuality of LifeSymptom Distress

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Area of Science:

  • Hepatology
  • Patient-Reported Outcomes
  • Symptom Science

Background:

  • Decompensated liver disease patients are typically staged by severity.
  • Current methods may not fully capture the patient experience of symptoms.

Purpose of the Study:

  • To classify end-stage liver disease (ESLD) patients by symptom severity, not just disease state.
  • To identify distinct physical and psychological symptom classes in ESLD patients.

Main Methods:

  • Recruited 191 ESLD patients (MELD-Na score ≥15) from liver clinics.
  • Utilized validated questionnaires including the Condensed Memorial Symptom Assessment Scale.
  • Employed latent class mixture modeling for cross-sectional data analysis.

Main Results:

  • Identified three distinct symptom classes: mild (26.7%), moderate (41.4%), and severe (31.9%).
  • Symptom class was independent of disease severity and demographics, except age.
  • Significant differences found in quality of life, optimism, and coping across symptom classes.

Conclusions:

  • Patient-reported symptom severity in ESLD is independent of objective disease severity.
  • Focusing on moderate/severe symptom classes and past complications can improve patient management.
  • This approach may enhance symptom management strategies for ESLD patients.