A183 ANXIETY IMPACTS HEALTH-RELATED QUALITY OF LIFE AND HOSPITALIZATIONS IN PATIENTS WITH CIRRHOSIS
Notice bibliographique
Résumé
Psychological distress is common in patients with cirrhosis. Depression has a significant effect on health-related quality of life (HRQoL), adaptive coping, functional status and mortality. The effect of anxiety on HRQoL and clinical outcomes is not as well understood. 1. Determine the prevalence of anxiety in cirrhosis and its association with clinical outcomes 2. Inform a rapid cirrhosis-specific anxiety screening tool by identifying multivariate predictors of anxiety using relevant clinical variables and subcomponents of the Hospital Anxiety and Depression Scale (HADS) Patients 18–80 years old with a diagnosis of cirrhosis were recruited consecutively from liver clinics at three tertiary care hospital sites in Alberta. Individuals were excluded if they: were disoriented to person, place, or time orhad overt hepatic encephalopathy; active malignancy or hepatocellular carcinoma outside of the Alberta liver transplant criteria; end-stage renal disease on dialysis; or were on antidepressants. Patient sociodemographic and cirrhosis characteristics were collected. Patients were identified as having anxiety using the Mini Neuropsychiatric Interview (MINI) modules for panic disorder, agoraphobia, social phobia, and generalized anxiety disorder. The HADS was also completed to assess anxiety. The chronic liver disease questionnaire (CLDQ) and EQ-VAS score were used to determine HRQoL and participants were followed up to 6 months to determine whether they had unplanned hospitalizations or deaths during that time. Of the 369 patients, 65 patients were excluded for being on anti-depressants, leaving a total of 304 patients. Of those, 17.1% had anxiety by the MINI. Multivariate analysis revealed active smoking and 3 HADS subcomponents as independent predictors of anxiety (Table 1). Anxious patients had lower HRQoL as assessed by CLDQ (P < 0.001) and EQ-VAS (P < 0.001) and were more frail by the Clinical Frailty score (P = 0.004). Although numerically higher, there were no statistically significant difference between anxious and non-anxious patients for hospitalizations or death within 6 months of testing (P = 0.14). The 8.2% of patients meeting diagnostic criteria for both anxiety and depression had worse CLDQ, EQ-VAS and Clinical Frailty scores than anxious-only or depressed-only patients. Anxiety is common in patients with cirrhosis and not routinely screened for. Anxiety has a significant impact on HRQoL and functional status, most pronounced in those patients with anxiety-depression overlap. Active smoking and three HADS subcomponents were identified as being independent predictors of anxiety. Multidisciplinary approaches targeting psychosocial and lifestyle factors as well as pharmacological therapies should be explored to treat anxiety in patients with cirrhosis. None
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».