Total and individual PBC-40 scores are reliable for the assessment of health-related quality of life in Greek patients with primary biliary cholangitis
Eirini I. Rigopoulou, Marianna Bakarozi, Ioannis Dimas, Konstantinos Galanis, Vasiliki Lygoura, Nikolaos Gatselis, M. Koulentaki, George N. Dalekos
Abstract
Abstract Background Primary biliary cholangitis (PBC) has been long associated with impairment of various aspects of health-related quality of life (HRQoL) with substantial differences among populations. This study evaluated for the first-time the HRQoL in Greek PBC patients in conjunction with clinical and laboratory parameters of patients. Methods We analyzed prospectively collected data regarding the HRQoL by using the PBC-40 and SF-36 questionnaires in 374 Greek PBC patients and 131 age- and sex-matched non-PBC controls. Results The PBC-40 questionnaire is a reliable tool for HRQoL assessment in Greek PBC patients (Cronbach's α > 0.7 for all domains). Implementation of PBC-40 and SF-36 demonstrated significant impairment of HRQoL in Greek PBC patients compared to controls ( P < 0.001 for all comparisons). Emotional dysfunction, social impairment, and fatigue (100%, 80.5% and 78%, respectively) were amongst those with the highest, while cognitive dysfunction (32%) with the least impact on quality of life. Fatigue was associated with female sex ( P = 0.02), longer disease duration ( P = 0.01), presence of cirrhosis ( P = 0.02) and positivity for PBC-specific ANA ( P < 0.05), while social dysfunction with increased age ( P < 0.001), longer disease duration ( P < 0.001) and presence of cirrhosis ( P = 0.004). Living in urban areas was linked to impaired social function ( P = 0.04), cognition ( P = 0.02), fatigue ( P = 0.04) and increased total PBC-40 score ( P = 0.01). Conclusions Implementation of PBC-40 and SF-36 revealed impaired HRQoL in Greek PBC patients with fatigue, social and emotional dysfunction exerting the highest impact. However, total, and individual PBC-40 scores were lower than that reported in studies from Northern/Central Europe and Canada. Deranged HRQoL was associated with severity of liver disease and presence of PBC-specific ANA.