Document Detail


Factors Related to Fatigue in Patients with Cirrhosis, Before and After Liver Transplantation.
MedLine Citation:
PMID:  21839709     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND & AIMS: We performed a prospective study to evaluate fatigue and identify potential determinants among patients with cirrhosis. We also studied the effects of liver transplantation on fatigue in these patients. METHODS: A total of 108 patients with cirrhosis being evaluated before liver transplantation completed the fatigue impact scale (FIS), the hospital anxiety and depression (HAD) scale, and the Short Form-36 (SF-36) . Results were compared with controls from the general population. Fasting, serum levels of insulin and glucose were measured in all patients. Levels of serum thyrotropin, free T3 and T4, cortisol, free testosterone, dehydroepiandrosterone sulfate, estradiol, interluekin-6, and tumor necrosis factor-α were measured in a subgroup of 80 patients. Transplant recipients were followed for 1 year. RESULTS: Compared to controls, patients with cirrhosis had more pronounced fatigue, based on higher FIS domain and total scores (P <.05), which were related to all SF-36 domains (r=-0.44 to -0.77, P <.001). All FIS scores improved significantly following liver transplantation, although physical fatigue levels remained higher than in controls (P <.05). In multivariate analysis, pre-transplant FIS scores were only related to depression, anxiety, cirrhosis severity, and low serum levels of cortisol (P <.05 for all). Impaired renal function and anemia were independent predictors of physical fatigue (P <.05). CONCLUSION: Fatigue is common among patients with cirrhosis and associated with impaired quality of life. Psychological distress, severity of cirrhosis, and low levels of cortisol determine general fatigue, whereas anemia and impaired renal function also contribute to physical fatigue. Physical fatigue remains of concern for patients that have received liver transplants for cirrhosis.
Authors:
Evangelos Kalaitzakis; Axel Josefsson; Maria Castedal; Pia Henfridsson; Maria Bengtsson; Irene Hugosson; Bengt Andersson; Einar Björnsson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-10
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  -     ISSN:  1542-7714     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Institute of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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