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dc.contributor.authorKalaitzakis, Evangelos
dc.contributor.authorJosefsson, Axel
dc.contributor.authorCastedal, Maria
dc.contributor.authorHenfridsson, Pia
dc.contributor.authorBengtsson, Maria
dc.contributor.authorHugosson, Irene
dc.contributor.authorAndersson, Bengt
dc.contributor.authorBjörnsson, Einar
dc.date.accessioned2013-08-29T09:37:34Z
dc.date.available2013-08-29T09:37:34Z
dc.date.issued2012-02
dc.date.submitted2013-08-29
dc.identifier.citationClin. Gastroenterol. Hepatol. 2012, 10(2):174-81, 181.e1en_GB
dc.identifier.issn1542-7714
dc.identifier.pmid21839709
dc.identifier.doi10.1016/j.cgh.2011.07.029
dc.identifier.urihttp://hdl.handle.net/2336/300251
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links field.en_GB
dc.description.abstractWe 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. 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 T(3) and T(4), cortisol, free testosterone, dehydroepiandrosterone sulfate, estradiol, interleukin-6, and tumor necrosis factor-α were measured in a subgroup of 80 patients. Transplant recipients were followed for 1 year. Compared with controls, patients with cirrhosis had more pronounced fatigue, on the basis of 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 after liver transplantation, although physical fatigue levels remained higher than in controls (P < .05). In multivariate analysis, pretransplant 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). 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 who have received liver transplants for cirrhosis.
dc.language.isoenen
dc.publisherElsevier Scienceen_GB
dc.relation.urlhttp://dx.doi.org/10.1016/j.cgh.2011.07.029en_GB
dc.rightsArchived with thanks to Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Associationen_GB
dc.subject.meshAnemiaen_GB
dc.subject.meshFatigueen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHydrocortisoneen_GB
dc.subject.meshLiver Cirrhosisen_GB
dc.subject.meshLiver Transplantationen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshQuality of Lifeen_GB
dc.subject.meshQuestionnairesen_GB
dc.subject.meshRenal Insufficiencyen_GB
dc.subject.meshSeverity of Illness Indexen_GB
dc.titleFactors related to fatigue in patients with cirrhosis before and after liver transplantation.en
dc.typeArticleen
dc.contributor.departmentInstitute of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.en_GB
dc.identifier.journalClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Associationen_GB
dc.rights.accessNational Consortium - Landsaðganguren
html.description.abstractWe 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. 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 T(3) and T(4), cortisol, free testosterone, dehydroepiandrosterone sulfate, estradiol, interleukin-6, and tumor necrosis factor-α were measured in a subgroup of 80 patients. Transplant recipients were followed for 1 year. Compared with controls, patients with cirrhosis had more pronounced fatigue, on the basis of 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 after liver transplantation, although physical fatigue levels remained higher than in controls (P < .05). In multivariate analysis, pretransplant 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). 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 who have received liver transplants for cirrhosis.


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