Preoperative quality of life in patients undergoing liver surgery

Surgical resection remains a cornerstone in the treatment of various hepatobiliary diseases. However, preoperative quality of life (QoL) in patients undergoing liver resection remains insufficiently studied. This study aimed to evaluate preoperative QoL and identify factors associated with impaired QoL in patients scheduled for liver surgery.

This single-center prospective observational study included patients undergoing liver resection for hepatobiliary diseases. Preoperative QoL was assessed using the Short Form-36 (SF-36) Health Survey, comprising eight domains and the Physical and Mental Component Summary (PCS and MCS) scores. Scores were compared with reference values from the 1998 German Federal Health Survey. Univariate and multivariable linear regression analyses were performed to identify preoperative predictors of QoL.

159 patients were included in the final analysis. Of these, 20 (12.6%) had benign lesions, 80 (50.3%) primary malignant tumors, and 59 (37.1%) secondary malignant tumors. Compared with the general German population, patients demonstrated significantly lower scores in 7 of 8 SF-36 domains as well as in both summary scores. Multivariable analyses identified female sex, absence of preoperative chemotherapy, anemia, history of depression, cardiovascular disease, and renal disease as independent predictors of impaired QoL across multiple domains. The mean R² across all multivariable models was 0.23.

Patients awaiting liver resection exhibit substantially impaired QoL compared with the general population. A combination of demographic, clinical, and laboratory factors influences preoperative QoL. Recognition of these factors may facilitate risk stratification, improve preoperative counseling, and support targeted interventions for patients at increased risk of impaired QoL.