Nutrition impact symptoms are related to malnutrition and quality of life – A cross-sectional study of patients with chronic liver disease

2020 ◽  
Vol 39 (6) ◽  
pp. 1840-1848 ◽  
Author(s):  
Catarina Lindqvist ◽  
Frode Slinde ◽  
Ammar Majeed ◽  
Matteo Bottai ◽  
Staffan Wahlin
Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1021
Author(s):  
Kazuki Ohashi ◽  
Madoka Ito ◽  
Megumi Kawakubo ◽  
Ikue Sato

Sarcopenia is associated with poor prognosis and decreased quality of life in patients with chronic liver disease (CLD). The present study aimed to clarify the dissemination of interventions such as evaluations, prevention efforts, and treatments for sarcopenia among patients in hepatology outpatient departments and wards in Japan, as well as examine the factors related to such dissemination. A cross-sectional study was performed involving nurses from hospitals accredited by the Japan Society of Hepatology. Participants completed a questionnaire regarding evaluations and interventions for sarcopenia in their department. Nurses from 72 outpatient departments and 162 wards provided responses to the questionnaire. Overall, 37.9% of outpatient departments and 37.6% of wards performed evaluations or interventions for sarcopenia. Outpatient departments and wards that evaluated sarcopenia or intervened held more workshops or training regarding sarcopenia than departments and wards that did not (outpatient departments: 52.0% vs. 12.2%, wards: 32.1% vs. 12.9%). Holding workshops or training regarding sarcopenia (outpatient departments; OR = 7.51, 95% confidence interval (CI): 2.12–26.6, wards; OR = 2.61, 95% CI: 1.11–6.15) was significantly associated with dissemination practices. These findings suggest that expanding knowledge of sarcopenia and developing practical skills among general nurses may aid in preventing sarcopenia among patients with CLD.


2020 ◽  
Vol 7 (6) ◽  
pp. 1013
Author(s):  
Mohammed Jaleel P. ◽  
S. Bhagyabati Devi ◽  
Ningthoukhongjam Reema ◽  
Thangjam Gautam Singh ◽  
Dhileeban Maharajan P.

Background: Hepatic osteodystrophy encompasses the spectrum of metabolic bone diseases in chronic liver disease (CLD) patients. CLD causing changes in BMD is well known. Although BMD evaluation in CLD cirrhosis are recommended by societies of British and American gastroenterology ,very less number of literature exist from India and none from the North-eastern region of India. Aim of the study to determine the association and severity of bone mineral density changes in patients with CLD and to correlate it with different aetiologies and severity of CLD.Methods: This cross-sectional study which included 79 patients with CLD was conducted in RIMS, Manipur from September 2017 to August 2019. All CLD patients of age 18-60 years were included. DEXA scan and other related blood investigations were performed.Results: Chronic alcohol intake (56.9%), viral infection (20.3%) and mixed (17.7%) were the main aetiology of CLD in our study. Seventy three (92.4%) of the total 79 patients had low BMD (Osteopenia in 29 (36.7%) and osteoporosis in 44 (55.7%) patients). Osteoporosis was detected in 53.4% of alcohol related Cirrhosis, 25%of viral liver disease. Majority of the severe CLD patients (Child class C) had osteoporosis (70.6%) as compared to less severe groups (23.5% and 36.4% in class B and A respectively).Conclusions: CLD patients have high prevalence of osteoporosis. Severity of liver disease, alcoholic liver disease, serum calcium and vitamin D deficiency predisposes to osteoporosis in these patients. Hence early screening of BMD is necessary in CLD patients.


2021 ◽  
Vol 11 (12) ◽  
pp. 1387
Author(s):  
Oana-Mihaela Plotogea ◽  
Gina Gheorghe ◽  
Madalina Stan-Ilie ◽  
Gabriel Constantinescu ◽  
Nicolae Bacalbasa ◽  
...  

The present study aims to assess the sleep characteristics and health-related quality of life (HRQOL) among patients with chronic liver diseases (CLDs), as well as the relationship between them. We conducted a prospective cross-sectional study, over a period of eight months, on patients with CLDs. Sleep was assessed by subjective tools (self-reported validated questionnaires), semi-objective methods (actigraphy), and HRQOL by using the 36-Item Short Form Survey (SF-36) and Chronic Liver Disease Questionnaire (CLDQ). The results indicated that 48.21% of patients with CLDs had a mean Pittsburgh Sleep Quality Index (PSQI) score higher than five, suggestive of poor sleep; 39.29% of patients had a mean Epworth Sleepiness Scale (ESS) score ≥11, indicative of daytime sleepiness. Actigraphy monitoring showed that patients with cirrhosis had significantly more delayed bedtime hours and get-up hours, more awakenings, and more reduced sleep efficacy when compared to pre-cirrhotics. The CLDQ and SF-36 questionnaire scores were significantly lower in cirrhotics compared to pre-cirrhotics within each domain. Moreover, we identified significant correlations between the variables from each questionnaire, referring to HRQOL and sleep parameters. In conclusion, sleep disturbances are commonly encountered among patients with CLDs and are associated with impaired HRQOL. This is the first study in Romania that assesses sleep by actigraphy in a cohort of patients with different stages of CLD.


Author(s):  
Hashik P. Muhammed ◽  
Kezhakkut Jayaraj

Background: Many previous studies concluded variation in the lipid parameters such as total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) with severity of liver disease. Hence, this study was conducted to find out the correlation of lipid profile in patients with severe liver disease.Methods: A cross sectional study which included 170 patients admitted with chronic liver disease. Severity of liver disease according to Child Pugh Turcotte Score. The patients were subjected to routine investigation and fasting lipid profile test. Correlation was studied using the Pearson correlation coefficient and the comparison of lipid parameters was also done.Results: Total of 170 consecutive chronic liver disease patients were analysed over a period of one year. Majority of the patients were of the age 51 to 60 years (39.8%). Among the total, 24 patients were in Child Pugh Turcotte Score class A, 47 patients were in class B and 52 were patients in class C. We could observe a significant (p<0.001) negative correlation of all the lipid profile parameters with the severity of liver disease.Conclusions: Serum TC, LDL TG and HDL were decreased in patients with cirrhosis and they are inversely correlated to severity of disease.


2021 ◽  
Author(s):  
Mohammad Farhadul Haque ◽  
ANM Shamsul Islam ◽  
Samina Pervin ◽  
Emily Akter ◽  
Mahmudul Hasan

Out-of-pocket (OOP) expenses for hospitalized patients with chronic liver disease (CLD) poses an economic challenge on affected household in the form of catastrophic health expenditure (CHE), distress financing and impoverishment. OOP Expenses data for hospitalized CLD patients from Bangladesh is scarce. This study aimed to estimate the OOP expenses and resulting CHE, distress financing and impoverishment among hospitalized patients with CLD. This cross-sectional study was conducted among conveniently selected 107 diagnosed CLD patients admitted at Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) aged 18 years and above. Data were collected from the respondents using a semi-structured questionnaire through face to face interview during discharge from hospital. Out of pocket expenditure for chronic liver disease in selected hospitals was Bangladeshi Taka (BDT) 19,262. Direct medical, direct non-medical and indirect cost was BDT 16,240; 2,165 and 1,510, respectively. Investigation cost and medicine cost contributed to 48.48% and 31.81% of the total OOP expenses, respectively. At 10% threshold level, 29% of the respondents were affected by CHE. 64.5% of the respondents were facing distress financing due to OOP expenses. Among the respondents, 1.9% slipped below the international poverty line of $1.90 (BDT 161.10, in 2019).There was statistically significant (p &lt; 0.05) difference among the mean OOP expenses for different etiological types of chronic liver disease. The study concluded that it requires establishing a more accessible and affordable decentralized health care system for CLD treatment along with the implementation of financial risk protection.


2021 ◽  
Vol 8 (27) ◽  
pp. 2373-2380
Author(s):  
Manabendra Nayak ◽  
Ghodke Chinmoy Pradeep

BACKGROUND Cirrhosis is a progressive clinical condition associated with considerable mortality and morbidity. It leads to a wide spectrum of characteristic clinical manifestations, mainly attributable to hepatic insufficiency and portal hypertension.1 In cirrhosis, primary diagnostic test for evaluation of upper-gastro-intestinal bleeding (UGIB) is endoscopy.2 The present study attempts to find out different clinical patterns of the chronic liver disease (CLD) with portal hypertension along with the endoscopic profile of the patients. METHODS It was a cross sectional study conducted in Down Town Hospital, Guwahati, Assam. RESULTS A cross sectional study was conducted at Downtown Hospital, Guwahati, Assam on patients diagnosed with chronic liver disease from 01 January 2017 to 31 January 2018. Male predominance was observed in this study with 84 % males and 16 % females. Male to female ratio was 5.25 : 1. Maximum patients (58 %) were observed in the age group of 40 to 60 years followed by 30 % in the age group of 60 to 80 years. The average age was 53.6 years. Most common aetiological factor was alcohol (66 %) followed by non-alcoholic steatohepatitis (NASH) (16 %). Other aetiologies were hepatitis-B, hepatitis-C and cryptogenic. 88 % cases were recorded in model for end stage liver disease (MELD) score range of 10 to 29. Ascites was noted in 88 % cases, of which 20 % had grade-1 and grade-2, 48 % had grade-3. Splenomegaly was noted in 70 % cases. Child-Pugh class-C consisted of 26 % cases (13) with grade-III varices followed by 18 % cases (9) with grade-II varices while Child-Pugh Class-B had 24 % cases (12) and 8 % cases (4) with grade-III and grade-II varices respectively. Child-Pugh class-A had all the cases with grade-I varices. CONCLUSIONS Alcoholism was the leading cause for cirrhosis followed by hepatitis-B, hepatitis-C, NASH and cryptogenic. Class-C had maximum number of cases with grade-III varices followed by class-B. MELD score ranged between 10 - 29 in majority. Severe anaemia was noted in 10 % cases. Thrombocytopenia a non-invasive indicator of oesophageal varices was noted in 70 % with different grades of oesophageal varices. KEYWORDS Endoscopy, Portal Hypertension, Chronic Liver Disease


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