BACKGROUND Patients with liver cirrhosis often suffer from complications such as ascites, gastrointestinal bleeding, and infections, resulting in impaired quality of life. Frequently, the close relatives of patients also suffer from a lower quality of life in chronic diseases. In recent years, acute-to-chronic liver failure has been defined as a separate entity with high mortality. Often several organs are affected which makes intensive care therapy necessary. Little is known about the influence of acute-on-chronic-liver failure (ACLF) on the quality of life of patients and the psychosocial burden on close relatives. AIM The purpose of this prospective study is to investigate the influence of decompensated liver cirrhosis and the onset of ACLF of the patient's' quality of life and the psychosocial burden of close relatives. METHOD In this non - randomized prospective cohort study a total of 63 patients with acute decompensation of liver cirrhosis and hospital admission were enrolled in the study. To assess the quality of life of patients, the disease specific CLDQ questionnaire was assessed. In addition. Quality of life and psychosocial burden of first degree relatives was measured using the generic SF-36 questionnaire as well as the Zarit Burden Score. RESULTS 21 of the 63 patients suffered from ACLF. Patients with ACLF showed a lower quality of life in terms of worries compared to patients with only decompensated liver cirrhosis (3,57 ± 1,17 vs. 4,48 ± 1,27; p value: 0,008) and increased systemic symptoms (3,29 ± 1,19 vs. 4,48 ± 1,58; p value: 0,004). The univariate analysis confirmed the link between the existence of an ACLF and the concerns of patients. (p value: 0,001). The organ failure score was significantly associated with overall CLDQ scores, especially with worries and systemic symptoms of patients. Interestingly the psychosocial burden and quality of life of close relative correlates with patient's quality of life and was influenced by the onset of an acute-on-chronic liver failure. CONCLUSION Patients with decompensated liver cirrhosis suffer from impaired quality of life. In particular, patients with ACLF have a significantly reduced quality of life. The extent of the psychosocial burden on close relative correlates with poor quality of life in patients with decompensated liver disease and is influenced by the existence of ACLF.

中文翻译：

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慢性慢性肝功能衰竭和代偿性肝硬化对患者及其近亲的社会心理负担和生活质量的影响。

背景技术肝硬化患者经常患有腹水，胃肠道出血和感染等并发症，导致生活质量受损。通常，患者的近亲也患有慢性疾病，生活质量较低。近年来，急性至慢性肝衰竭已被定义为具有高死亡率的独立个体。通常，几个器官受到影响，因此有必要进行重症监护治疗。肝慢性急性衰竭（ACLF）对患者生活质量的影响以及近亲的社会心理负担知之甚少。目的这项前瞻性研究的目的是调查失代偿性肝硬化，急性心力衰竭的发作对患者生活质量和近亲心理负担的影响。方法在这项非随机的前瞻性队列研究中，共有63例急性肝硬化代偿失调并入院的患者入选。为了评估患者的生活质量，评估了针对疾病的CLDQ问卷。此外。使用通用的SF-36问卷以及Zarit Burden评分来测量一级亲属的生活质量和社会心理负担。结果63例患者中有21例患有ACLF。与仅有失代偿性肝硬化的患者相比，ACLF患者的生活质量较低（3,57±1,17 vs. 4,48±1,27； p值：0.008）和全身症状增加（3） ，29±1,19对4,48±1,58； p值：0.004）。单变量分析证实了ACLF的存在与患者关注之间的联系。（p值：0.001）。器官衰竭评分与总体CLDQ评分显着相关，尤其与患者的忧虑和全身症状有关。有趣的是，近亲的社会心理负担和生活质量与患者的生活质量相关，并受慢性慢性肝衰竭发作的影响。结论代偿性肝硬化患者的生活质量受损。特别是，ACLF患者的生活质量明显下降。失代偿性肝病患者近亲的社会心理负担程度与生活质量差有关，并受ACLF的存在影响。有趣的是，近亲的社会心理负担和生活质量与患者的生活质量相关，并受慢性慢性肝衰竭发作的影响。结论代偿性肝硬化患者的生活质量受损。特别是，ACLF患者的生活质量明显下降。失代偿性肝病患者近亲的社会心理负担程度与生活质量差有关，并受ACLF的存在影响。有趣的是，近亲的社会心理负担和生活质量与患者的生活质量相关，并受慢性慢性肝衰竭发作的影响。结论代偿性肝硬化患者的生活质量受损。特别是，ACLF患者的生活质量明显下降。失代偿性肝病患者近亲的社会心理负担程度与生活质量差有关，并受ACLF的存在影响。ACLF患者的生活质量明显下降。失代偿性肝病患者近亲的社会心理负担程度与生活质量差有关，并受ACLF的存在影响。ACLF患者的生活质量明显下降。失代偿性肝病患者近亲的社会心理负担程度与生活质量差有关，并受ACLF的存在影响。