Inadequate social support decreases survival in decompensated liver cirrhosis patients

被引:6
|
作者
Morales, Natalia Garcia [1 ,2 ,3 ]
de la Varga, Margarita Fernandez [4 ]
Perez, Javier Pumares [5 ]
Rodriguez, Martin Menendez [2 ,3 ,6 ]
Morato, Sagrario Gutierrez [7 ]
Cejas, Carmen Castillo [7 ]
Aguilera, Victoria [8 ,9 ]
Benlloch, Salvador [9 ,10 ]
Rodriguez, Luis Menendez [11 ]
Pillado, Teresa Seoane [2 ,12 ]
Vieito, Noel Pin [13 ]
Cubiella, Joaquin [2 ,9 ,13 ]
机构
[1] Complexo Hosp Univ Vigo CHUVI, Gastroenterol & Hepatol Dept, Vigo, Spain
[2] Galicia Sur Hlth Res Inst IIS Galicia Sur, Vigo, Spain
[3] Univ Santiago de Compostela, Fac Med, Epidemiol Dept, Santiago De Compostela, Spain
[4] Hosp Univ & Politecn La Fe, Gastroenterol & Hepatol Dept, Valencia, Spain
[5] Complejo Hosp Univ Santiago de Compostela, Oncol Dept, Santiago De Compostela, Spain
[6] Xerencia Xest Integrada Vigo, Ctr Salud Lavadores, Vigo, Spain
[7] Hosp Univ & Politecn La Fe, Social Work Dept, Valencia, Spain
[8] Hosp Univ & Politecn La Fe, IIS La Fe, Hepatol & Liver Transplantat Unit, Valencia, Spain
[9] Inst Salud Carlos III, Ciberehd, Madrid, Spain
[10] Hosp Arnau Vilanova, Gastroenterol & Hepatol Dept, Valencia, Spain
[11] Complejo Hosp Univ A Coruna, Hosp Oza, Psychiat Dept, La Coruna, Spain
[12] Univ A Coruna, Dept Hlth Sci, Unit Prevent Med & Publ Hlth, INIBIC, La Coruna, Spain
[13] Complexo Hosp Univ Ourense, Gastroenterol & Hepatol Dept, Orense, Spain
来源
GASTROENTEROLOGIA Y HEPATOLOGIA | 2023年 / 46卷 / 01期
关键词
Liver cirrhosis; Mortality; Preventive health services; Survival analysis; PROGNOSTIC INDICATORS; NATURAL-HISTORY; MORTALITY; NETWORKS; DISEASE; RISK; EPIDEMIOLOGY; LONELINESS; DEPRESSION; EVENTS;
D O I
10.1016/j.gastrohep.2022.04.006
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Introduction: Inadequate social support is associated with higher mortality both in the general population and in patients with chronic diseases. There are no studies that have described social support in liver cirrhosis and its impact on prognosis. Objectives: To analyze the impact social support has in the survival of patients with decom-pensated cirrhosis. Methods: Prospective multicentric cohort study (2016-2019). Patients with decompensated liver cirrhosis were included. Epidemiological, clinical and social variables were collected, using the validated Medical Outcomes Study Social Support Survey, with a 12-month follow-up. Results: A total of 127 patients were included, of which 79.5% were men. The most common etiology of cirrhosis was alcohol (74.8%), mean age was 60 years (SD 10.29), mean MELD was 15.6 (SD 6.3) and most of the patients had a Child -Pugh B (53.5%) or C (35.4%). In the assessment of social support, we observed that most of the patients (92.2%) had adequate global support. At the end of the follow-up (median 314 days), 70.1% of the patients survived. The 1-year survival rate in patients with inadequate global social support was 30%, compared to 73.5% in the presence of social support. In multivariate Cox regression analysis, inadequate social support predicted survival with an adjusted HR of 5.5 (95% CI 2,3-13,4) independently of MELD (HR 1.1, 95% CI 1-1.2), age (HR 1, 95% CI 1--1.1) and hepatocarcinoma (HR 10.6, 95% CI 4.1-27.4). Conclusion: Adequate social support improves survival in liver cirrhosis, independently of clin-ical variables. Social intervention strategies should be considered for their management. (c) 2022 Elsevier Espana, S.L.U. All rights reserved.
引用
收藏
页码:28 / 38
页数:11
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