Dear Editor,

We read with great interest the article by Yepes-Barreto and colleagues¹, which aimed to explore the association between quality of life and sexual function in female patients with liver cirrhosis through the use of questionnaires and clinical assessments. We believe that this study is highly relevant for improving the care of women with liver cirrhosis. However, we would like to share some comments regarding the variables employed. We were struck by the omission of certain sociodemographic variables in the analysis, as these are cited in several studies as significant factors contributing to reduced quality of life in cirrhotic patients. For instance, in the study by Teshome and colleagues, low educational attainment, lack of access to health insurance, and residence in rural areas were identified as factors that diminish patients’ quality of life². Similarly, other studies have assessed economic stability-related variables. In the study by Pradhan and colleagues, unemployment and low income were found to negatively impact patients’ quality of life³. Additionally, research by Souza and colleagues established a relationship between low household income and poor quality of life in these patients, reporting a statistically significant value of p = 0.03, underscoring the importance of this variable in the assessment of quality of life⁴.

It is also important to highlight the availability of disease-specific questionnaires, such as the Liver Disease Quality of Life (LDQOL) 1.0 instrument. This tool incorporates the SF-36 questionnaire and adds 12 disease-specific scales, providing a more comprehensive assessment of liver disease-related quality of life. This instrument has been validated in countries such as Brazil, where it demonstrated strong reliability in studies involving cirrhotic patients⁵. Notably, this tool has also been employed in Colombia to assess the quality of life of liver transplant patients, yielding significant findings when comparing pre- and post-transplant outcomes⁶.

Based on the literature review, we conclude that studies should include sociodemographic factors to enhance their findings, as these variables act as confounding factors that indirectly affect patients’ quality of life, particularly in low-resource settings. We also recommend the future adaptation of liver cirrhosis-specific questionnaires to obtain a more detailed analysis of quality-of-life outcomes.

Referencias

Yepes Barreto IJ, Arboleda Rivero LA, García Doria ML. Calidad de vida y función sexual en mujeres con cirrosis hepática en Colombia. Rev Colomb Gastroenterol. 2023;38(4):439-47. https://doi.org/10.22516/25007440.1063

Teshome E, Hailu W, Adane A, Belayneh Melese E, Abebaw Angaw D, Tarekegn GE. Clinical and individual factors of quality of life of chronic liver disease patients at University of Gondar comprehensive specialized hospital, Northwest Ethiopia 2022. Medicine (Baltimore). 2023;102(45):e35425. https://doi.org/10.1097/MD.0000000000035425

Pradhan RR, Kafle Bhandari B, Pathak R, Poudyal S, Anees S, Sharma S, et al. The Assessment of Health-Related Quality of Life in Patients With Chronic Liver Disease: A Single-Center Study. Cureus. 2020;12(9):e10727. https://doi.org/10.7759/cureus.10727

Souza NP, Villar LM, Garbin AJ, Rovida TA, Garbin CA. Assessment of health-related quality of life and related factors in patients with chronic liver disease. Braz J Infect Dis. 2015;19(6):590-5. https://doi.org/10.1016/j.bjid.2015.08.003

Dias Teixeira MC, de Fátima Gomes de Sá Ribeiro M, Strauss E. A new insight into the differences among non-cirrhotic and cirrhotic patients using the liver disease quality of life instrument (LDQOL). Ann Hepatol. 2005;4(4):264-71.

Mejía G, Gómez MT, Moreno-Medina K. Evaluación de la calidad de vida relacionada con la salud pre y post trasplante hepático, en pacientes de un hospital de alta complejidad. Psychol. 2019;13(1):65-72. https://doi.org/10.21500/19002386.3721

Notes

Author notes

*Correspondence: Ivanoba Emylin Cuadros-Véliz. ivanoba.cuadros@upsjb.edu.pe