Pruritus is associated with severely impaired quality of life in patients with primary sclerosing cholangitis

被引:29
作者
Gotthardt, Daniel Nils [1 ]
Rupp, Christian [1 ]
Bruhin, Miriam [1 ]
Schellberg, Dieter [2 ]
Weiss, Karl H. [1 ]
Stefan, Reinhard [1 ]
Donnerstag, Nadine [1 ]
Stremmel, Wolfgang [1 ]
Loewe, Bernd [2 ,3 ]
Juenger, Jana [2 ]
Sauer, Peter [1 ]
机构
[1] Univ Heidelberg Hosp, Dept Internal Med 4, D-69120 Heidelberg, Germany
[2] Univ Heidelberg Hosp, Dept Internal Med 2, D-69120 Heidelberg, Germany
[3] Univ Med Ctr Hamburg Eppendorf, Dept Psychosomat Med & Psychotherapy, Hamburg, Germany
关键词
primary sclerosing cholangitis; pruritus; quality of life; INFLAMMATORY-BOWEL-DISEASE; PRIMARY BILIARY-CIRRHOSIS; NATURAL-HISTORY; DEPRESSION; OUTCOMES; IMPACT;
D O I
10.1097/MEG.0000000000000223
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objectives Quality of life, fundamental to the individual patient, has shown a lack of correlation with severity in research on several diseases. Thus, we aimed to identify factors associated with quality of life in patients with primary sclerosing cholangitis. Methods The Short Form Health Survey and the Patient Health Questionnaire were used to assess quality of life and depression. Complete data sets of 113 patients were analyzed for correlation with sex, age, presence of concomitant inflammatory bowel disease and dominant stenosis, frequency of pruritus, and Mayo Risk Score. Results Physical functioning decreased with age (P<0.001). Further, women experienced more prominent role limitations because of physical (P<0.03) and emotional (P<0.01) problems. Although patients' quality of life and depression scores were only slightly lower than normal, more frequent pruritus was associated with a considerable reduction in quality of life in terms of physical and social functioning, general and mental health, bodily pain, vitality, and roles (because of physical problems) (P<0.01). It did not differ significantly according to the Mayo Risk Score or the presence of dominant stenoses. Depression scores were only significantly affected in patients with more frequent pruritus. Conclusion Pruritus severely affects quality of life in patients with primary sclerosing cholangitis and is associated with depression to varying extents, although the most commonly used parameters of disease severity do not correspond to quality of life in these patients. These findings need to be considered with respect to treatment outcomes and indications for liver transplantation. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
引用
收藏
页码:1374 / 1379
页数:6
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