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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2015

Open Access 01-12-2015 | Study protocol

Assessment of nutritional status and health-related quality of life before and after liver transplantation

Authors: María Teresa García-Rodríguez, María del Carmen Piñón-Villar, Beatriz López-Calviño, Alejandra Otero-Ferreiro, Francisco Suárez-López, Manuel Gómez-Gutiérrez, Salvador Pita-Fernández

Published in: BMC Gastroenterology | Issue 1/2015

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Abstract

Background

Patients with chronic liver disease frequently suffer from malnutrition, together with a decline in their health-related quality of life.
This study was carried out with the aim of evaluating the nutritional status, complications of medical and surgical care, anxiety, health-related quality of life and dependence level on basic and instrumental activities of daily living in pre- and post-liver transplant patients.

Methods/Design

A prospective observational study with follow-up of patients on the waiting list for liver transplants who subsequently received a transplant at the University Hospital Complex in A Coruña during the period 2012–2014 (n = 110).
All the patients will be followed-up for a maximum of 6 months. For survivors, assessments will be re-evaluated at one, three and six months post- transplant.
Informed consent of the patient and ethical review board approval was obtained (Code: 2010/081 and 2010/082).
The following variables will be studied: socio-demographic data, reason for the transplant, comorbidity (Charlson Score), analytical parameters, time on transplant waiting list and post-transplant complications. A trained nurse will evaluate the following for each patient: nutritional indices, anthropometric variables and handgrip strength. Validated questionnaires will be used to determine the patients’ nutritional status (Subjective Global Assessment), anxiety (STAI questionnaire), Health-Related Quality of Life (LDQoL 1.0 questionnaire), dependence (Barthel Index and Lawton-Brody Scale), nursing diagnoses (NANDA) and post-transplant quality indicators.
Multiple linear/logistic regression models will be used to identify variables associated with the events of interest. Changes in nutritional status, quality of life and dependence over time will be analysed with linear mixed-effects regression models.
Actuarial survival analysis using Kaplan-Meier curves, Cox regression and competitive risk will be performed
Concordance between the different scores that assess nutritional status and interobserver agreement regarding nursing diagnoses will be studied using the statistical Kappa index and Bland Altman method.

Discussion

The risk of malnutrition can be considered as a possible prognostic factor in transplant outcomes, associated with anxiety, health-related quality of life and dependence.
For this reason we consider interesting to perform a prospective follow-up study of patients who require a transplant to survive, studying their nutritional status and health-related quality of life.
Appendix
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Metadata
Title
Assessment of nutritional status and health-related quality of life before and after liver transplantation
Authors
María Teresa García-Rodríguez
María del Carmen Piñón-Villar
Beatriz López-Calviño
Alejandra Otero-Ferreiro
Francisco Suárez-López
Manuel Gómez-Gutiérrez
Salvador Pita-Fernández
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2015
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-015-0232-3

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