症状负担的明显的纵向轨迹预测了末期肝病的临床结果
Lissi Hansen1, Michael F Chang2,3, Shirin Hiatt1
1School of Nursing, Oregon Health & Science University, Portland, Oregon, USA.
Clinical and translational gastroenterology
|June 26, 2024
概括
末期肝病 (ESLD) 患者表现出两种症状轨迹:高/未减轻或低/改善. 高症状负担与增加的死亡率和更差的生活质量有关,无论疾病的严重程度如何.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 临床医学 临床医学
- 患者的治疗结果.
背景情况:
- 关于末期肝病 (ESLD) 症状轨迹的数据有限.
- 了解症状负担对于管理ESLD患者至关重要.
研究的目的:
- 在12个月内确定ESLD成年人的明显症状负担轨迹.
- 探索影响这些轨迹的因素及其与临床结果的关联.
主要方法:
- 一项前性研究,从肝病学诊所招募了192名患者.
- 使用了对身体和心理症状的验证措施.
- 使用潜增长混合建模和生存/增长建模进行数据分析.
主要成果:
- 确定了两个症状轨迹:32.3%的高/不减轻症状和67.7%的低/改善症状.
- 高症状负担使所有原因死亡的风险增加了一倍,并与较差的生活质量相关.
- 症状轨迹与MELD 3.0分数无关,而是根据性别,社会支持和宗教信仰来预测.
结论:
- 在ESLD中存在两个不同的症状体验表型,独立于疾病严重程度.
- 这些表型与性,社会支持,宗教信仰和死亡率有关.
- 识别患有高症状负担的患者是优化护理和改善结果的关键.
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