Association Between Quality of Life Defined by EuroQol Group 5 Dimension and Composite Inferior Outcome Among Inpatients with Cirrhosis

Figures & data

Table 1 Hospital Cirrhotic Inpatients’ Baseline Characteristics (n = 420)

	Total (n = 420)	EQ-5D Utility Value ≤0.59 (n = 76)	EQ-5D Utility Value>0.59 (n = 344)	P
Age (years)	64 (57, 69)	67 (60, 71)	63 (57, 69)	0.010
Gender, n (%)				0.311
Male	210 (50.0)	42 (55.3)	168 (48.8)	0.149
Female	210 (50.0)	34 (44.7)	176 (51.2)
BMI (kg/m^2)	23.9 (20.7, 27.0)	22.6 (18.5, 25.4)	24.2 (21.0, 27.2)	0.001
Etiology, n (%)				0.377
Viral infection	102 (24.3)	16 (21.1)	86 (25.0)
Alcohol-associated	95 (22.6)	17 (22.4)	78 (22.7)
AILD/cholestatic	132 (31.4)	21 (27.6)	111 (32.3)
Cryptogenic/MAFLD	91 (21.7)	22 (28.9)	69 (20.0)
EGVB, n (%)	297 (70.7)	47 (61.8)	250 (72.7)	0.070
Ascites, n (%)	250 (59.5)	57 (75.0)	193 (56.1)	0.002
Hepatic encephalopathy, n (%)	28 (6.7)	8 (10.5)	20 (5.8)	0.136
CTP score	7 (6, 9)	8 (6, 9)	7 (6, 9)	0.224
CTP class, n (%)				0.226
A	141 (33.6)	21 (27.6)	120 (34.9)
B+C	279 (66.4)	55 (72.4)	224 (65.1)
MELD	8.5 (5.0, 11.5)	8.2 (4.8, 10.8)	8.6 (5.1, 11.7)	0.268
MELD-Na	9.7 (6.1, 12.9)	9.3 (5.8, 12.6)	9.9 (6.3, 12.9)	0.347
Na (mmol/L)	140 (138, 142)	139 (136, 141)	140 (138, 142)	0.001
K (mmol/L)	3.8 (3.5, 4.1)	3.7 (3.4, 4.1)	3.9 (3.5, 4.1)	0.326
Albumin (g/L)	28 (25, 32)	28 (25, 32)	28 (25, 32)	0.518
ALT (U/L)	22 (15, 37)	20 (15, 42)	23 (15, 36)	0.326
ALP (U/L)	89 (67, 138)	106 (75, 167)	88 (65, 129)	0.028
TBIL (μmol/L)	21.3 (14.0, 35.6)	22.1 (13.3, 35.6)	20.9 (14.0, 36.0)	0.777
Platelet (10^9/L)	85 (59, 124)	106 (60, 144)	82 (59, 118)	0.033
Hemoglobin (g/L)	88 (71, 110)	87 (63, 144)	88 (72, 112)	0.068
Creatinine (μmol/L)	59 (49, 73)	65 (54, 105)	59 (48, 72)	0.014
PT-INR	1.3 (1.2, 1.4)	1.3 (1.2, 1.5)	1.3 (1.2, 1.4)	0.509
Utility value	0.77 (0.65, 1.00)	0.37 (0.18, 0.53)	0.80 (0.71, 1.00)	<0.001
Death or readmission, n (%)	179 (42.6)	51 (67.1)	128 (37.2)	<0.001

Abbreviations: EQ-5D, EuroQol Group 5 Dimension; BMI, body mass index; AILD, autoimmune liver disease; MAFLD, metabolic dysfunction-associated steatotic liver disease; EGVB, esophagogastric variceal bleeding; CTP, Child-Turcotte-Pugh; MELD, Model for End-stage Liver Disease; Na, sodium; K, potassium; ALT, alanine aminotransferase; ALP, alkaline phosphatase; TBIL, total bilirubin; PT-INR, prothrombin time-international normalized ratio.

Table 2 Univariate and Multivariate Cox’s Regression Analyses for 1-Year All-Cause Mortality or Readmission

Variable	Univariate Analysis			Multivariate Analysis
	HR	95% CI	P	HR	95% CI	P
Age (years)	1.01	0.99, 1.02	0.428
Sex, n (%)
Male	1.30	0.96, 1.74	0.086
Female	Ref
BMI (kg/m^2)	1.00	0.96, 1.03	0.749
Ascites (yes vs no)	1.36	1.00, 1.85	0.051
CTP score	1.10	1.02, 1.19	0.018	1.10	1.01, 1.21	0.033
Hemoglobin (g/L)	1.00	1.00, 1.00	0.073
Platelet (10^9/L)	1.00	1.00, 1.00	0.231
Na (mmol/L)	0.96	0.94, 0.98	0.001	0.97	0.94, 1.00	0.034
K (mmol/L)	0.99	0.94, 1.04	0.577
ALP (U/L)	1.00	1.00, 1.00	<0.001	1.00	1.00, 1.00	<0.001
Albumin (g/L)	0.96	0.93, 0.97	0.004
TBIL (μmol/L)	1.00	1.00, 1.01	0.004
PT-INR	0.99	0.94, 1.05	0.693
Creatinine (μmol/L)	1.00	1.00, 1.01	0.001	1.00	1.00, 1.01	0.012
Utility value
≤0.59	2.63	1.89, 3.64	<0.001	2.18	1.53, 3.10	<0.001
>0.59	Ref

Abbreviations: HR, hazard ratio; CI, confidence interval; BMI, body mass index; CTP, Child-Turcotte-Pugh; Na, sodium; K, potassium; ALP, alkaline phosphatase; TBIL, total bilirubin; PT-INR, prothrombin time-international normalized ratio.

Figure 1 Adjusted HR for 1-year all-cause mortality or readmission across HRQoL assessed by each domain of the EQ-5D questionnaire derived from the five models. All models were adjusted for CTP score, serum sodium, ALP and creatinine.

Abbreviations: HR, hazard ratio; HRQoL, health-related quality of life; EQ-5D, EuroQol Group 5 Dimension; CTP, Child-Turcotte-Pugh; ALP, alkaline phosphatase.

Figure 2 Cox regression model for 1-year all-cause mortality or readmission. Adjusted HRs are indicated by a solid line and 95% confidence intervals by red color derived from RCS with 3 knots (P = 0.461 for non-linearity).

Abbreviations: HR, hazard ratio; CI, confidence interval; RCS, restricted cubic spline.

Figure 3 Survival curves in relation to 1-year all-cause mortality stratified by EQ-5D utility value.

Abbreviation: EQ-5D, EuroQol Group 5 Dimension.