Quality of life in refractory ascites: Transjugular intrahepatic portal-systemic shunting versus medical therapy

Mical S. Campbell, Colleen M. Brensinger, Arun J. Sanyal, Chris Gennings, Florence Wong, Kris V. Kowdley, Timothy M McCashland, K. Rajender Reddy

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Uncontrolled studies suggest that transjugular intrahepatic portal-systemic shunting (TIPS) may improve quality of life in patients with refractory ascites. We hypothesized that any improvement of quality of life in patients with TIPS would be matched in controls due to the competing effects of improved ascites and worsened hepatic encephalopathy. Thus, an analysis of quality of life was performed using original data from the North American Study for the Treatment of Refractory Ascites, a multicenter trial of 109 patients randomized to TIPS or repeated large volume paracentesis (LVP) for refractory ascites. Short form 36 (SF-36) surveys were completed at baseline and at 6- and 12-month follow-up. Variables analyzed were: randomization group, number of LVP performed, cumulative volume from LVP, shortness of breath, abdominal distention, abdominal pain, diuretic usage, confusion, hospitalizations, and emergency room visits. Outcomes were changes in physical component scale (PCS) and mental component scale (MCS) of SF-36 results. We constructed multivariable, mixed effects models, including randomization group and baseline MCS and PCS. Changes in PCS and MCS from baseline were similar between the two randomization groups. In multivariate analysis, PCS improvement was associated with lack of confusion, improved ascites, and lack of hospitalizations, but not directly with randomization group. Improvement in MCS was associated with randomization to TIPS and lack of confusion. In conclusion, patients with refractory ascites randomized to TIPS or repeated LVP had similar changes in quality of life. Competing effects of hepatic encephalopathy, requirement for repeated LVP, and need for hospitalizations explain similar changes in quality of life between the two groups.

Original languageEnglish (US)
Pages (from-to)635-640
Number of pages6
JournalHepatology
Volume42
Issue number3
DOIs
StatePublished - Sep 1 2005

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Paracentesis
Ascites
Random Allocation
Quality of Life
Hospitalization
Hepatic Encephalopathy
Therapeutics
Diuretics
Dyspnea
Abdominal Pain
Multicenter Studies
Hospital Emergency Service
Multivariate Analysis

ASJC Scopus subject areas

  • Hepatology

Cite this

Campbell, M. S., Brensinger, C. M., Sanyal, A. J., Gennings, C., Wong, F., Kowdley, K. V., ... Reddy, K. R. (2005). Quality of life in refractory ascites: Transjugular intrahepatic portal-systemic shunting versus medical therapy. Hepatology, 42(3), 635-640. https://doi.org/10.1002/hep.20840

Quality of life in refractory ascites : Transjugular intrahepatic portal-systemic shunting versus medical therapy. / Campbell, Mical S.; Brensinger, Colleen M.; Sanyal, Arun J.; Gennings, Chris; Wong, Florence; Kowdley, Kris V.; McCashland, Timothy M; Reddy, K. Rajender.

In: Hepatology, Vol. 42, No. 3, 01.09.2005, p. 635-640.

Research output: Contribution to journalArticle

Campbell, MS, Brensinger, CM, Sanyal, AJ, Gennings, C, Wong, F, Kowdley, KV, McCashland, TM & Reddy, KR 2005, 'Quality of life in refractory ascites: Transjugular intrahepatic portal-systemic shunting versus medical therapy', Hepatology, vol. 42, no. 3, pp. 635-640. https://doi.org/10.1002/hep.20840
Campbell MS, Brensinger CM, Sanyal AJ, Gennings C, Wong F, Kowdley KV et al. Quality of life in refractory ascites: Transjugular intrahepatic portal-systemic shunting versus medical therapy. Hepatology. 2005 Sep 1;42(3):635-640. https://doi.org/10.1002/hep.20840
Campbell, Mical S. ; Brensinger, Colleen M. ; Sanyal, Arun J. ; Gennings, Chris ; Wong, Florence ; Kowdley, Kris V. ; McCashland, Timothy M ; Reddy, K. Rajender. / Quality of life in refractory ascites : Transjugular intrahepatic portal-systemic shunting versus medical therapy. In: Hepatology. 2005 ; Vol. 42, No. 3. pp. 635-640.
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