Journal of clinical and experimental hepatology · 2026
Quality of Life Among Patients With Liver Cirrhosis in Egypt: An Analysis of Clinical and Psychological Predictors.
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Ashour Reham, Ghazy Ramy M, Hussein Mohamed F, Abdel-Fattah Mahmoud A, Mohamed Aliaa Y, Shiba Hoda A A, Elkhadry Sally W
Аннотация
BACKGROUND/AIMS: Quality of life (QoL) is significantly impaired by chronic liver disease (CLD) due to socioeconomic, psychological, and physical reasons. In a cohort of Egyptian cirrhosis patients, this study evaluated QoL and its determinants and examined association between QoL, disease severity, and mental health.
METHODS: In this cross-sectional study at the National Liver Institute (from January to May 2024), 197 cirrhotic patients completed the Chronic Liver Disease Questionnaire (CLDQ) and Depression Anxiety Stress Scales-21 (DASS-21). Child-Pugh and model for end-stage liver disease (MELD) scores were used to assess disease severity. Spearman correlation, Mann-Whitney U, and Kruskal-Wallis tests evaluated nonparametric data, and ridge and gamma regressions examined QoL determinants.
RESULTS: The median age was 62.0 (11.0) years; most patients had compensated cirrhosis and mild disease severity. Substantial psychological distress was observed, with (mild to very severe) depression, anxiety, and stress reported in 31.0%, 40.6%, and 21.8%, respectively. Significant negative correlations were found between CLDQ scores and all DASS-21 domains (ρ (rho) = -0.625 to -0.697). Poorer QoL was independently associated with higher DASS subscale scores (all P < 0.001), ascites (ridge -0.627; unit-gamma EXP(B) 0.37, P < 0.001), and moderate-severe Child-Pugh class (ridge -0.300, P = 0.020; EXP(B) 0.50, P < 0.001). Better QoL was associated with health insurance (ridge 0.280, P = 0.027; EXP(B) 1.40, P = 0.040) and a greater number of rooms in the household (ridge 0.179, P = 0.053; EXP(B) 1.53, P < 0.001).
CONCLUSION: QoL in Egyptian cirrhotic patients is significantly affected by psychological distress, disease severity, and socioeconomic factors, highlighting the need for integrated biopsychosocial management approaches.
METHODS: In this cross-sectional study at the National Liver Institute (from January to May 2024), 197 cirrhotic patients completed the Chronic Liver Disease Questionnaire (CLDQ) and Depression Anxiety Stress Scales-21 (DASS-21). Child-Pugh and model for end-stage liver disease (MELD) scores were used to assess disease severity. Spearman correlation, Mann-Whitney U, and Kruskal-Wallis tests evaluated nonparametric data, and ridge and gamma regressions examined QoL determinants.
RESULTS: The median age was 62.0 (11.0) years; most patients had compensated cirrhosis and mild disease severity. Substantial psychological distress was observed, with (mild to very severe) depression, anxiety, and stress reported in 31.0%, 40.6%, and 21.8%, respectively. Significant negative correlations were found between CLDQ scores and all DASS-21 domains (ρ (rho) = -0.625 to -0.697). Poorer QoL was independently associated with higher DASS subscale scores (all P < 0.001), ascites (ridge -0.627; unit-gamma EXP(B) 0.37, P < 0.001), and moderate-severe Child-Pugh class (ridge -0.300, P = 0.020; EXP(B) 0.50, P < 0.001). Better QoL was associated with health insurance (ridge 0.280, P = 0.027; EXP(B) 1.40, P = 0.040) and a greater number of rooms in the household (ridge 0.179, P = 0.053; EXP(B) 1.53, P < 0.001).
CONCLUSION: QoL in Egyptian cirrhotic patients is significantly affected by psychological distress, disease severity, and socioeconomic factors, highlighting the need for integrated biopsychosocial management approaches.