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- Title
Symptom Frequency and Distress Underestimated in Decompensated Cirrhosis.
- Authors
Hansen, Lissi; Chang, Michael F.; Hiatt, Shirin; Dieckmann, Nathan F.; Lyons, Karen S.; Lee, Christopher S.
- Abstract
Background: Studies assessing multiple symptoms and the distress of these symptoms in decompensated cirrhosis are lacking. Aims: The aims of this study were to assess symptom prevalence and distress among patients with decompensated cirrhosis and to describe medical management of the most prevalent symptoms. Methods: Patients were recruited from hepatology clinics within two health-care systems. Eligibility criteria included a model for end-stage liver disease (MELD-Na) score ≥15. Patients completed the Condensed Memorial Symptom Assessment Scale and Patient Health Questionnaire. Comparative statistics were used to analyze the cross-sectional survey data. Results: Of the sample (n = 146), most patients were Child-Turcotte-Pugh (CTP) class B (49.7%) and C (46.2%). Mean age was 56.5 years, 65.1% were male, and 88.4% were white. Average MELD-Na score was 19.1 ± 4.5. The most prevalent symptoms were lack of energy and feeling drowsy while the most distressing were lack of energy and difficulty sleeping. Only 24 patients (16.4%) were treated for their difficulty sleeping with sleep medication. Importantly, those prescribed sleep medications had similar distress (3.9 ± 1.2 vs. 3.5 ± 1.2, p = 0.229) compared with patients not prescribed sleep medications. Opioids were prescribed to 57 (39.0%) patients; antidepressants to 34 (23.3%). Forty patients (27.4%) who reported moderate or greater depression were not prescribed an antidepressant. Conclusions: The study highlights the multiple symptoms and distress experienced by patients with decompensated cirrhosis, and the need for improved medical management by health-care providers through enhanced awareness and attention to these complex symptoms. Future research should focus on improvements in symptom management.
- Subjects
CIRRHOSIS of the liver; HYPNOTICS; SYMPTOMS; PSYCHOLOGICAL distress; PATIENTS' attitudes
- Publication
Digestive Diseases & Sciences, 2022, Vol 67, Issue 8, p4234
- ISSN
0163-2116
- Publication type
Article
- DOI
10.1007/s10620-021-07216-7