BACKGROUND AIM Perception of the ascites burden and its effects on quality of life may be different between sexes. This study assessed sex differences in perception of ascites burden and its impact on health related QoL (HRQoL) in patients with recurrent or refractory ascites. METHODS The North American Consortium for the Study of End-stage Liver Disease prospectively enrolled outpatients with cirrhosis and large ascites requiring repeat large volume paracenteses. Demographics, laboratory results, co-morbidities, medications, frailty measurements, self-reported questionnaires related to functional status, physical activities, and HRQoL (generic = SF36 & ascites specific = ascites Q) were compared between sexes. RESULTS 392 men (59.6±10.7yrs) and 184 women (59.5±11.1yrs) with predominantly alcohol related liver disease 51% and 43% respectively), median MELD-Na: 13, were enrolled. Both groups had similar co-morbidities and cirrhosis complications, ascites duration and severity, and frailty scores (p=0.94). Women had more symptoms related to their ascites (Ascites Q score =66±21 vs. 60±21 in men, p=0.001) (higher value = feeling worse). 35% of women felt depressed versus 22% of men (p=0.0009), with lower mental but not physical functioning components of SF36 (p=0.019). Women continued to conduct their daily activities as adequately as men as indicated by Duke Status Activity index (p=0.27) and Godin Leisure Activity Index (p=0.47). CONCLUSIONS Women with cirrhosis and ascites experienced worse emotional HRQoL than men without difference in daily function. Our analyses underscore the differences in the lived experience of women versus men with cirrhosis and highlight the need for patient-reported metrics to provide patient-centered care.

中文翻译：

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失代偿性肝硬化和腹水门诊患者报告结局的性别差异和对腹水负担的感知。腹水负担感知的性别差异。


背景 目的 对腹水负荷及其对生活质量影响的看法可能因性别而异。本研究评估了复发性或难治性腹水患者对腹水负荷感知的性别差异及其对健康相关 QoL （HRQoL） 的影响。方法 北美终末期肝病研究联盟前瞻性招募了需要重复大量穿刺术的肝硬化和大腹水门诊患者。在性别之间比较了人口统计学、实验室结果、合并症、药物、虚弱测量、与功能状态相关的自我报告的问卷、身体活动和HRQoL（通用=SF36和腹水特异性=腹水Q）。结果 392 名男性 （59.6±10.7 岁） 和 184 名女性 （59.5±11.1 岁），主要为酒精相关肝病 51% 和 43%），中位 MELD-Na：13，共入组。两组合并症和肝硬化并发症相似，腹水持续时间和严重程度以及虚弱评分 （p=0.94）。女性有更多与腹水相关的症状 （腹水 Q 评分 =66±21 vs. 男性 60±21，p = 0.001）（更高的值 = 感觉更糟）。35% 的女性感到抑郁，而男性为 22% （p = 0.0009），SF36 的精神成分较低，但身体功能成分较低 （p = 0.019）。正如 Duke Status 活动指数 （p=0.27） 和 Godin 休闲活动指数 （p=0.47） 所示，女性继续像男性一样充分地进行日常活动。结论 肝硬化腹水女性的情绪 HRQoL 比男性差，日常功能无差异。我们的分析强调了女性肝硬化患者与男性患者生活经历的差异，并强调了患者报告指标提供以患者为中心的护理的必要性。